LEWIS  S.MATTHEWS  &  CO. 
i  MBBICAIBOORS 


THI9 


DONATED 


cu*J& 


HOW  TO  SUCCEED 


IN  THE 


PRACTICE  OF  MEDICINE 


By 

•; 

JOSEPH  MCDOWELL   MATHEWS,   M. D.,  LL. D. 

PRESIDENT  OF  AMERICAN  MEDICAL  ASSOCIATION,  1898— '9 

Author  of  "Mathews  on  Diseases  of  the  Rectum";  Ex-President  Mississippi  Valley 
Medical  Association,  Kentucky  State  Medical  Society,  American  Proctologic 
Society,    Louisville  Surgical   Society,    Louisville  Clinical  Society; 
President  Kentucky  State  Board  of  Health ;  Honorary  Fellow 
American  Association  Obstetricians  and  Gynecolo- 
gists; Professor  of  Surgery,  Hospital  Medical 
College;   Late  Professor  of  Surgery, 
Kentucky  School  of  Medicine,  etc. 


PHILADELPHIA  AND  LONDON 

W.  B.  SAUNDERS  &  COMPANY 

1905 


Copyright,  1905,  by  W.  B.  Saunders  &  Company. 


PREGS    OF 
PHILADELPHIA 


THIS  BOOK  is  AFFECTIONATELY  DEDICATED  TO 

M:Y 


FOB  TWENTY-FIVE  YEAES  SHE  HAS  BEEN  MY  "  PARTNEK  "  IN  LOVE  AND 
AFFECTION;  AND  TO  HER  BARE  GOOD  JUDGMENT,  EXCELLENT  ADVICE 
AND  STEADFASTNESS  I  OWE  MUCH  OF  WHATEVER  SUCCESS  MAY  HAVE 
COME  TO  ME  IN  THE  MEDICAL  PROFESSION. 

THE  AUTHOR. 


PREFACE 

For  the  past  twenty-five  years  it  has  been  my 
pleasure  to  be  connected  in  a  professorial  way  with 
several  medical  colleges  in  this  city.  During  this 
time  I  have  frequently  talked  to  the  students  about 
"the  business  side"  of  the  medical  profession. 
They  have  often  asked  me  to  reduce  these  thoughts 
to  writing;  hence  this  book.  I  make  free  use  of 
"the  personal  pronoun"  because  I  regard  this 
more  in  the  nature  of  a  "  heart-to-heart "  talk  with 
the  "boys"  than  otherwise.  I  insert  my  photo- 
graph because  they  have  requested  it.  The  book 
is  enlarged  that  it  may  interest  all  members  of  the 
medical  profession,  and  the  laity  are  earnestly 
requested  to  read  it.  Many  ' '  fads  and  frauds " 
are  dealt  with  without  "fear  or  favor."  It  has 
been  painful  to  me  to  see  many  of  my  professional 
friends  die  and  leave  their  families  in  actual  want. 
The  reason  is  plain  that  it  was  either  their  own 
fault  or  the  fault  of  their  clientele,  and  how  to  pre- 
vent this  happening  to  others  is  the  main  object  of 
the  book.  I  have  tried  to  write  "a  guide  to 
success "  intended  principally  for  medical  students 
and  the  young  practitioners  of  medicine.  Those 
who  have  already  succeeded  and  are  satisfied  need 


VI  PREFACE 

not  read  the  book  unless  they  want  to.  The  wives 
of  doctors,  I  believe,  will  be  pleased  with  the  senti- 
ments herein  expressed. 

The  administration  of  drugs  has  not  been  con- 
sidered at  all,  but  ' '  Art  in  Medicine  "  has  received 
full  attention.  Character,  which  is  the  very  foun- 
dation of  success  in  any  calling,  is  fully  dwelt  on, 
together  with  the  many  attributes  that  go  to  make 
up  a  gentleman,  and  the  possession  of  which  is  nec- 
essary to  insure  success  in  medicine.  The  ' '  foibles 
and  follies  "  of  society  are  held  up  to  view,  and  the 
life  of  the  doctor  pictured  as  it  really  is.  I  hope 
that  the  book  may  be  of  some  comfort  and  advan- 
tage to  a  few  struggling  young  doctors  at  least. 
The  ' '  lights  and  shadows  of  a  doctor's  life  "  receive 
equal  attention,  and  to  relieve  the  monotony  a 
jocular  vein  is  interspersed  here  and  there. 

THE  AUTHOR. 

LOUISVILLE,  KENTUCKY, 

923  Fourth  Avenue. 


CONTENTS 

CHAPTER  I 

PAGE 

REQUIREMENTS  FOR  ENTERING  THE  MEDICAL  PRO- 
FESSION  i 

Examining  Boards;  College  Education;  Common  School 
Education  ;  Self-Education ;  Character ;  Generosity ; 
Humbleness;  Decision;  Perseverance;  Positiveness;  Am- 
bition; Habit;  Cheerfulness;  Courage;  Patience;  Man- 
ner; Diplomacy;  Sobriety. 

CHAPTER  II 
LOCATION, 23 

Home;  The  Old  Folks;  The  Mother-in-law;  The  Office; 
The  "Sign";  Personal  Appearance;  How  to  Begin;  A 
Larger  Field  ;  Don't  Move. 

CHAPTER  III 

MARRIAGE, 47 

Mother;  Wife;  Reasons,  Pro  and  Con;  A  Legal  Eua.ol- 
ment  to  Control  Marriage;  Reasons  for  Not  Marrying. 

CHAPTEH  IV 
ETHICS, „     , 56 

1 '  Do  Unto  Others  as  You  Would  Have  Others  Do  Unto 
You." 

CHAPTER  V 
THE  FIRST  YEAR 57 

Justice;  The  Poor;  Treatment  of  Other  Doctors;  Gossip; 
Sarcasm;  Secrets;  "The  Clock";  The  First  Call;  Pull- 
ing the  First  Tooth;  The  "Old  Maid";  An  Hour  of 
Sorrow;  The  Hypocrite;  Consultation;  "Society"; 
Secrets. 


tall  CONTENTS 

CHAPTER  VI 

PAGE 

SPECIALTIES  IN  MEDICINE, 93 

The  General  Practitioner;  The  Surgeon;  Medical  Socie- 
ties; Medical  Journals;  A  Library;  How  to  Be  a  Special- 
ist; Are  Specialties  in  Medicine  Necessary? 

CHAPTER  VII 
THE  BUSINESS  SIDE  OF  IT, 109 

The  Telephone;  The  Three  Learned  Professions;  Does 
It  Pay?;  The  First  Citizen;  A  Chance;  A  Life  Policy; 
Accounts;  Investments;  Compare  Earnings;  How  to 
Succeed;  Is  the  Doctor  a  Poor  Man?;  Parents'  Advice  to 
Daughters. 

CHAPTER  VIII 
THE  YOUNG  VERSUS  THE  OLD  DOCTOR 130 

Claims  Compared;  Experience;  A  Mountain  Patient; 
The  Mountaineer:  Reverence;  Partnership;  The  Profes- 
sional Nurse. 

CHAPTER  IX 
THE  COUNTRY  VERSUS  THE  CITY  DOCTOR,       .     .     .  145 

The  Country  Home;  The  Old  Days;  A  Call  in  the 
Country;  A  Call  in  the  City;  The  Workingman;  The 
Old  Woman  at  the  Gate;  The  Man  Who  Never  Works; 
The  Black  «« Mammy  ";  American  Medicine;  Heredity; 
Brusqueness;  Sincerity;  Pessimist;  Optimist. 

CHAPTER  X 
ART  IN  MEDICINE, 167 

Old  Family  Doctor;  A  Mind  Diseased;  The  Will;  Faith; 
Grit;  Good  Humor;  Exercise;  Food;  Mind  and  Body; 
Unrest;  Insomnia;  Overworked  Employes;  Mr.  Pick- 
wick; Music;  Flowers;  Books. 


CONTENTS  1* 

CHAPTER  XI 

PAGE 

SOME  RARE  TYPES  THAT  You  WILL  MEET,    .     .     .194 

The  "  Smooth  "  Doctor;  The  «•  Eccentric  "  Doctor;  The 
"Political"  Doctor;  The  "Church"  Doctor;  The 
"Lodge"  Doctor;  The  "Fool"  Doctor;  The  "News- 
paper" Doctor;  The  "  Loud  "  Doctor;  The  "  Crank  " 
Doctor;  The  "  Book-worm  "  Doctor;  The  "Over-polite" 
Doctor;  The  "Effeminate"  Doctor;  The  "Unsuccess- 
ful "  Doctor. 


CHAPTER  XII 

LIGHTS  AND  SHADOWS,    ..........  207 

Age;  What  Is  Left  after  Youth  Is  Gone;  Retrospection; 
The  End:   ihe  Reward. 


ILLUSTRATIONS. 

OPPOSITE  PAGE 

THE  AUTHOR, Frontispiece 

THE  COMING  OF  THE  OLD  FOLKS, 32 

THE  HANGING  OF  THE  SIGN, 44 

THE  OLD  DOCTOR, 132 

MEDITATION, ...  208 

THE  END, e    .    .  212 


How  TO  SUCCEED  IN  THE  PRACTICE 
OF  MEDICINE 


CHAPTER  I 

REQUIREMENTS  FOR  ENTERING  THE  MEDICAL 
PROFESSION 

It  is  not  within  the  province  of  the  writer  to 
determine  the  ' '  requirements  "  in  order  to  enter  the 
medical  profession,  nor  is  it  within  the  scope  of  this 
book  to  even  discuss  the  subject,  for  it  is  written 
for  the  edification  of  those  who  have  already  met 
the  ' '  requirements, "  and  have  entered  or  are  about 
to  enter  into  the  practice  as  full-fledged  doctors. 
Yet  so  much  has  been  written  pro  and  con  on  this 
subject  that  the  writer  feels  that  he  will  be  excused 
for  a  few  words  concerning  it. 

The  cry  for  a  "  higher  medical  education "  is 
resounding  throughout  the  land  as  it  never  has 
before. 

The  Medical  Examining  Boards  are  compelling 
the  medical  colleges  to  advance  their  standard,  and 
each  year  advances  are  made  in  this  direction.  It 
is  bound  to  result  in  '  *  a  survival  of  the  fittest, "  and 
the  college  that  can  not  comply  with  the  demand 


HOW  TO  SUCCEED  IN 


must  of  necessity  go  to  the  wall.  Many  hardships 
will  result,  and  bitter  disappointments.  It  may  be 
that  the  rich  will  be  made  richer  and  the  mighty 
be  made  mightier,  but  it  does  seem  that  this 
result  must  obtain.  It  is  urged  by  some  that  as 
this  course  goes  on  many  worthy  but  poor  young 
men  will  be  prevented  from  entering  the  medical 
profession  because  of  the  want  of  sufficient  means 
to  do  so,  and  that  splendid  material  is  lost  for  the 
reason  that  the  applicant  has  not  had  the  good 
fortune  to  be  college-bred.  Without  attempting 
to  discuss  any  phase  of  the  question,  the  author 
desires  to  give  expression  to  a  few  thoughts  and 
narrate  a  few  personal  observations.  After  an 
experience  extending  over  twenty-five  years  as 
teacher  in  a  medical  college  he  begs  to  submit 
the  following  conclusions : 

1.  The  better  educated  one  is,  the  better  pre- 
pared he  is  to  understand  the  teachings  of  the 
great  Science  of  Medicine. 

2.  Upon  the  foundation  of  learning  as  laid  by  a 
common  school  education  men  have  attained  to  the 
highest  positions  in  the  medical   profession,   both 
as  teachers  and  practitioners. 

3.  Many  men  with  the  highest  education  that 
could  be  afforded  by  Harvard,  Yale,  or  Princeton 
have  signally  failed  as  practitioners  of  medicine. 


THE  PRACTICE  OF  MEDICINE  3 

4.  Many  men  of  self  education  have  attained 
to  the  highest  positions  known  in  the  medical 
profession. 

It  has  often  been  a  thing  of  common  comment 
that  the  student  who  stood  highest  in  his  classes 
and  succeeded  in  capturing  all  the  prizes  failed 
often  to  make  a  living  as  a  practitioner  of  medicine. 
So,  at  last,  it  is  left  with  the  individual  to  carve  for 
himself  a  name  or  pursue  the  path  that  leads  to 
fortune.  This  power  is  inborn  in  some,  but  that  it 
is  acquired  by  others  can  not  be  gainsaid.  The 
brilliant  mind  that  comes  of  heredity  is  often 
equaled,  if  not  surpassed,  by  the  plodding,  deter- 
mined, and  self-reliant  student.  We  have  but  to 
look  at  the  illustrious  example  as  given  in  the  life 
of  Mr.  Lincoln — 

The  man  who  sped  the  woodman's  team, 
And  deepest  sunk  the  ploughman's  share, 

And  pushed  the  laden  raft  astream, 
Of  fate  before  him  unaware. 

for  a  verification  of  this  statement.  Born  of  com- 
mon parentage,  with  no  education  save  that  instilled 
into  him  by  nature's  teaching ;  without  money  or 
friend,  he  ascended  to  the  highest  gift  within  the 
power  of  the  American  people.  Men  have  attained 
great  prominence  in  the  medical  profession  whose 
only  claim  to  a  literary  education  was  the  knowl- 


4  HOW  TO  SUCCEED  IN 

edge  gleaned  in  a  common  school.  Nevertheless, 
it  must  be  understood  that  the  higher  education  is 
the  more  desirable,  and  every  one  contemplating  a 
medical  career  should  strive  for  a  college  training 
and  a  classical  proficiency.  Beside  the  educa- 
tional requirements  necessary  to  become  a  profi- 
cient doctor  in  medicine  there  are  other  attributes 
that  are  absolutely  essential.  Without  their  pos- 
session one  would  be  a  complete  failure  in  this 
great  calling.  I  would  beg  the  indulgence  of  the 
reader  whilst  enumerating  them : 

Character.  First  of  all  it  can  be  definitely 
asserted  that  character  must  be  the  foundation  of  a 
business  or  professional  calling,  of  whatever  kind. 
It  is  unnecessary  to  add  that  good  must  prefix 
character  always.  Webster  defines  character  to  be 
1 '  a  peculiar  or  distinctive  quality. "  There  are  many 
qualities  that  go  to  make  up  character.  Let  me 
therefore  say,  that  in  order  to  succeed  in  the  medical 
profession  one  must  first  be  honest;  honest  to 
yourself  and  honest  to  your  patron.  The  practice 
of  medicine  is  no  child's  play,  for  the  pursuit  of  it 
involves  life  and  death.  It  is  bad  enough  to 
"cheat  at  cards"  or  in  "swapping  horses,"  but 
you  must  never  waver  from  the  perfect  path  of 
truth  in  dealing  with  the  sick  or  afflicted.  To 
pretend  what  you  are  not  is  but  to  count  yourself 


THE  PRACTICE  OF  MEDICINE  5 

a  charlatan  of  the  worst  degree.  If  you  do  not 
know,  say  so,  and  call  for  one  that  does  know. 
Much  better  to  be  accounted  a  fool  than  sacrifice 
one  human  life.  Never  in  your  bigotry  suppose 
that  you  know  it  all,  or  that  there  may  not  be  others 
who  know  more  than  you.  Honesty,  like  virtue,  is 
its  own  reward,  and  the  people  will  not  be  slow  in 
detecting  this  sterling  quality  in  you.  Your  name 
should  be  a  synonym  for  honesty,  as  your  word 
should  be  as  good  as  your  bond. 

Second,  you  must  be  just.  This  will  be  a  try- 
ing ordeal  with  you  oftentimes.  It  is  hard  enough 
to  be  just  to  your  neighbor,  but  you  will  find  it 
much  more  difficult  to  be  just  to  your  fellow- 
practitioner,  especially  so  if  he  happens  to  be  your 
rival.  Don't  be  so  narrow-minded  as  not  to  see 
the  good  in  others — although  you  may  hate  them. 
If  a  patient  is  in  great  peril,  do  not  hesitate  to 
avail  yourself  of  your  enemy's  knowledge,  if  it  can 
be  had.  You  owe  this  much  to  your  patient.  It 
is  narrated  of  a  distinguished  physician  who  lived 
in  Louisville  that  at  one  time  he  called  in  consul- 
tation a  fellow-practitioner  with  whom  he  was  not 
on  speaking  terms.  Upon  one  occasion,  after  the 
day  of  consultation,  he  was  met  on  the  street  by 
the  doctor  whom  he  had  called  in  consultation  and 
the  doctor  spoke  to  him.  In  answer  he  received 


0  HOW  TO  SUCCEED  IN 

this  stinging  rebuke,  "Do  not  presume,  sir,  to 
speak  to  me.  I  do  not  regard  you  as  a  gentleman, 
and  wish  no  speaking  acquaintance  with  you. "  It 
might  not  be  out  of  place  here  to  admonish  my 
younger  professional  friends  against  the  habit  of 
making  enemies  of  others — it  may  be  contending 
doctors.  I  use  the  term  habit  because  it  has  often 
occurred  to  me  to  be  such.  Too  often  it  is,  that 
because  a  doctor  dares  locate  in  a  place  where 
there  are  other  doctors,  he  is  looked  upon  as 
an  intruder  and  enemy  of  the  balance.  What 
sheer  nonsense!  You  do  not  possess  a  community 
simply  because  you  live  in  it,  and  no  right  of  pos- 
session is  given  you  by  long  habitation.  Greet  the 
newcomer  as  one  gentleman  should  greet  another, 
yea,  more,  greet  him  as  a  brother.  For  is  he  not 
your  brother  ?  What  a  family  the  medical  profes- 
sion is,  indeed,  banded  together  for  nobler  purposes 
than  actuates  any  other  human  organization.  A 
single  purpose  there  should  be,  no  animosities,  dis- 
sensions, or  jealousies  in  it.  To  relieve  the  sick 
and  afflicted,  to  care  for  the  widow  and  the  orphan, 
to  help  those  who  can  not  help  themselves;  to  give 
advice  when  advice  is  most  needed;  to  hear  the 
secrets  of  the  ' '  inner  chamber, "  and  help  quiet  the 
storm.  What  a  wonderful  and  important  work  is 
intrusted  into  the  hands  of  the  family  doctor!  Why 


THE  PRACTICE  OF  MEDICINE  7 

disturb  these  missions  by  quarreling  and  fretting 
with  each  other?  Turn  a  deaf  ear  to  the  tales  of 
idle  gossips  who  are  continually  seeking  to  make 
an  enemy  of  your  professional  brother.  One  half 
of  such  are  mere  fabrications,  and  many  times  the 
other  half  told  for  selfish  purposes.  Even  granting 
that  your  brother  has  erred,  count  it  human,  and 
go  on  your  way  rejoicing;  for,  after  all,  "what's  the 
use?"  Be  just,  and  wrong  no  man. 

Third,  you  must  be  generous.  Many  times  you 
will  realize  that  your  services  must  be  given  with- 
out the  faintest  idea  of  reward.  I  should  qualify 
this  word,  for  the  universal  acceptance  would  be 
reward  in  a  monetary  way,  but  to  the  honest  and 
just  physician  it  means  much  more.  A  word  of 
praise,  a  simple  clasp  of  the  hand,  a  ' '  thank  you  " 
— these  mean,  often  mean,  much  more  than  a 
reward  in  money.  But  I  must  stick  to  my  text, 
and  say  that  ' '  your  services  must  often  be  given 
without  reward."  When  life  is  at  stake  you  must 
not  stop  to  consider  whether  you  will  even  be 
thanked  for  your  efforts,  to  say  nothing  of  a  settle- 
ment with  cash.  There  are  people  in  the  world  so 
dead  to  all  sense  of  gratitude  that  they  will  even 
forget  to  thank  you  for  your  services,  much  less 
pay  you  for  the  same;  but  you  can  not  afford  to 
make  a  note  of  it.  If  they  are  poor — unable  to 


8  HOW  TO  SUCCEED  IN 

reward  you — render  the  service  just  as  positively 
as  if  they  were  rich  and  able  to  lavish  upon  you 
great  gifts.  But  thanks  to  the  eternal  fitness  of 
things,  it  will  be  found  that  it  is  the  poor  that  ren- 
der unto  the  physician  just  praise,  and  a  word  from 
them  comes  as  a  benediction  to  the  overworked 
and  underpaid  doctor.  It  should  be  your  special 
delight  and  bounden  duty  to  help  them  in  time  of 
need,  and  count  it  done  for  humanity's  sake.  If, 
as  I  have  said,  you  should  be  just  in  your  dealings 
with  men,  I  would  also  add  be  generous.  Let  this 
thought  actuate  you  when  dealing  with  the  faults 
of  others.  There  are  ' '  none  perfect,  no,  not  one  " ; 
so  be  generous,  and  do  not  attribute  evil  to  men's 
actions;  and  even  if  convinced  that  they  are  at 
fault,  try  and  overlook  it — rebuke  if  you  please, 
but  forget.  It  is  well  with  you  if  you  are  far- 
seeing  and  able  to  judge  men  correctly.  The 
man  that  is  a  good  judge  of  human  nature  has 
already  acquired  a  gift  that  will  be  of  incalculable 
benefit  to  him  in  the  practice  of  medicine. 

Fourth,  be  humble  in  your  attainments.  If  it 
has  been  your  good  fortune  to  attain  to  great  emi- 
nence in  your  profession,  do  not  seek  to  place 
it  above  your  fellow-workers;  remember  the  sim- 
plicity of  Lincoln,  Marion  Sims,  and  Ephraim 
McDowell.  Even  if  a  man  is  great,  he  can  so 


THE  PRACTICE  OF  MEDICINE  9 

"strut  and  paw"  as  to  render  himself  disgusting. 
A  bigot  is  as  much  to  be  despised  as  a  fool.  Men 
have  been  known  to  lose  all  their  influence,  which 
required  years  to  obtain,  by  bragging  of  their 
accomplishments.  In  the  pretender  these  things 
are  laughed  to  scorn  by  the  populace,  but  for  the 
man  of  real  genius  to  adopt  such  methods — why, 
it  amounts  to  an  unintentional  moral  suicide. 
Whatever  may  be  your  position,  however  mighty, 
be  humble,  seeking  no  place  above  your  fellows. 
Decision.  There  is  no  one  trait  in  a  man's  char- 
acter that  goes  further  to  insure  his  success  in  any 
undertaking  as  decision  of  purpose.  To  the  force 
of  will  many  men  owe  their  supremacy  in  the  medi- 
cal as  well  as  the  other  professions.  The  man  who 
is  not  possessed  of  this  quality  will  make  many  fatal 
mistakes.  The  world  despises  a  weak  man,  easily 
led  by  others,  with  no  will  of  his  own,  or  afraid  to 
use  it;  he  becomes  a  mere  puppet,  and  is  used  by 
designing  men  to  accomplish  their  ends,  and  with- 
out profit  to  himself.  If  you  once  decide  that  a 
thing  is  right,  then  dare  to  maintain  it.  The  man 
who  vacillates — is  one  thing  to-day,  another  to- 
morrow— can  not  be  trusted  for  anything;  even  his 
friendship  would  not  be  sought  by  any  man,  and 
his  advice  would  go  unheeded.  "Very  like  a 
whale  "  is  too  often  the  caliber  of  men  who,  if  they 


IO  HOW  TO  SUCCEED  IN 

had  some  force  of  will,  would  amount  to  some- 
thing in  the  world.  Do  not  agree  with  people 
unless  you  believe  they  are  right,  for  this  very 
disposition  to  please  will  bring  you  into  ridicule. 
Before  asserting  or  acting  upon  any  proposition  be 
sure  you  are  right,  then  go  ahead — not  to  a  degree 
of  obstinacy  or  in  a  dogmatic  way,  but  one  can 
be  positive  without  being  offensive.  Respect  the 
opinions  of  others,  for  they  may  be  right  and  you 
wrong.  If  you  are  convinced  even  against  your 
will,  have  the  manhood  to  acknowledge  it.  If  you 
have  not  this  virtue  of  stability,  cultivate  it,  and  it 
will  pay  you  well. 

Perseverance.  Being  possessed  of  a  firmness  of 
character  which  enables  you  to  decide  things  aright 
for  yourself,  you  must  persevere  in  the  accomplish- 
ing of  that  which  you  have  designed.  Perseverance 
will  be  used  here  as  synonymous  with  energy,  for  a 
slothful  man  will  accomplish  but  little  in  this  wide- 
awake, busy  world.  Oliver  Wendell  Holmes  said: 
"  The  human  race  is  divided  into  two  classes,  those 
who  go  ahead  and  do  something,  and  those  who  sit 
still  and  inquire."  Competition  is  brisk  in  every 
walk  of  life,  and  includes  the  medical  profession. 
Many  times  you  will  feel  like  turning  back  or  giving 
up  your  profession  for  some  other  calling  that  holds 
out  a  greater  promise  for  rapid  advancement  or  the 


THE  PRACTICE  OF  MEDICINE  1 1 

accumulation  of  wealth,  but  don't  do  it.  It  is  those 
that  stick  who  ' '  get  there. "  After  you  have  grasped 
success — true,  after  years  of  hard  labor — you  will 
look  back  on  your  career  and  thank  the  stars  that 
you  did  not  "desert  the  ranks."  Be  a  captain,  a 
leader  in  everything  you  undertake.  It  was  once 
said  of  a  certain  gentleman  that  he  would  have 
been  a  bishop  in  any  calling  that  he  might  have 
selected.  Be  a  ' '  bishop  "  in  your  calling. 

Positiveness.  It  is  better  to  be  positive,  although 
occasionally  wrong,  than  to  go  through  life  always 
full  of  doubt  and  governed  by  indecision.  The 
man  who  is  thoroughly  convinced  of  the  equity  of 
his  own  position,  and  that  he  has  a  work  of 
his  own  in  the  world  to  perform,  rarely  has  time 
enough  to  attend  to  the  affairs  of  his  neighbors; 
and,  needless  to  say,  the  man  who  attends  to  his 
own  affairs,  which  he  understands,  is  always  in  a 
more  fortunate  condition,  so  far  as  success  is  con- 
cerned, than  is  the  man,  regardless  of  what  his 
methods  may  be,  who  devotes  a  large  amount  of 
his  time  to  the  personal  affairs  of  those  about  him. 
A  man  must  not  only  attend  to  his  own  affairs,  but 
must  do  what  he  has  to  do  with  positiveness.  Posi- 
tiveness is,  to  some  extent,  born  in  a  man,  but  that 
it  can  be  developed  is  also  a  certainty.  The  posi- 
tiveness of  perfect  knowledge  is  best.  No  man 


12  HOW  TO  SUCCEED  IN 

achieves  anything  worthy  until  he  learns  the  power 
of  conviction — until  he  feels  that  he  can  accomplish 
something  if  he  wills  it  strong  enough  and  long 
enough.  The  world  stands  aside  for  the  man  who 
has  a  program,  a  mission,  a  calling  to  do  that  which 
he  feels  a  throbbing  compulsion  within  him  to  do. 
Stoutly  affirm  your  ability  to  do  what  you  under- 
take; every  affirmative  strengthens  your  position. 
One  of  the  best  strengtheners  of  character  and  de- 
velopers of  stamina,  generally,  is  to  assume  the  part 
you  wish  to  play,  to  stoutly  assert  the  possession  of 
whatever  you  lack.  If  you  are  deficient  in  courage, 
staying  power,  pluck,  or  determination,  learn  to 
assert  vigorously  these  qualities  as  your  own  by  a 
divine  right.  Be  thoroughly  convinced  that  they 
belong  to  you;  that  you  should  possess  them,  and 
that  you  do;  then  you  will  strengthen  your  success 
and  position  wonderfully.  You  have  heard  of  the 
country  dog  who  came  to  town  and  was  so  awed 
by  the  presence  of  city  dogs  that  he  lost  all  cour- 
age, or  had  none,  and  betook  himself  to  the  fence- 
corner;  when  attacked,  seeing  that  he  had  to  assert 
himself  or  be  whipped,  he  "screwed  his  courage 
to  the  sticking-place, "  and  the  result  was  that  he 
'  *  cleaned  out "  the  whole  set.  So  it  is  with  men ;  if 
they  have  courage,  they  can  carry  their  convictions 
to  the  utmost  point  and  overcome  all  adversaries. 


THE  PRACTICE  OF  MEDICINE  13 

Ambition.  I  would  not  have  you  ' '  throw  away 
ambition,"  but  rather  to  cultivate  the  spirit.  It 
was  said  of  a  gentleman  who  recently  died  that 
"he  was  ambitious — striving  not  to  gain  honors, 
but  to  do  good."  How  aptly  this  would  apply 
to  one  in  your  profession  that  had  pursued  the 
proper  course.  Ambitious  not  to  be  crowned,  but 
to  serve;  not  to  receive  applause,  but  to  obtain 
results.  Ambitious  to  relieve  the  sick  and  comfort 
the  dying.  I  once  heard  of  a  young  doctor  who 
said  that  it  was  his  ambition  to  do  the  largest 
practice  in  his  city.  I  wonder  if  he  meant  for 
adulation,  or  for  the  purpose  of  doing  good.  If 
you  are  meritorious  and  possess  the  other  qualities 
necessary,  you  will  be  blessed  with  as  much  prac- 
tice as  you  can  attend  to.  I  recently  heard  a  doctor 
boast  that  he  saw  sixty  patients  daily  in  private 
practice.  I  know  a  distinguished  physician  that 
devotes  two  hours  to  the  examination  of  each 
patient  to  whom  he  is  called  in  consultation.  Which 
one  of  these  would  you  prefer  to  attend  you  if  you 
were  sick?  Ambition:  Yes,  to  be  a  good  doctor, 
capable  and  wise. 

Habit.  Habit  makes  or  unmakes  a  man,  and 
each  individual  is  responsible  for  his  being  good 
or  being  bad,  for  habit  acts  for  good  or  evil. 
There  is  no  progression  without  habit,  and  if  we 


14  HOW  TO  SUCCEED  IN 

cease  to  operate  the  will  which  creates  it  we  retro- 
grade.    A    man  who  has    not   the  habit  of   self- 
cultivation  soon  loses  out.     Without  it  at  the  age 
of  seventy,  we  have  not  progressed  a  jot  or  tittle 
over  what  we  were  at  thirty.     Gladstone,  at  the  age 
of  seventy-five,  was  a  much  abler  man,  mentally, 
than  when  he  was  forty  years  of  age.      It  is  pro- 
verbial that  we  are  slaves  to  habit;  we  say  of  a 
man  who  smokes  or  chews    tobacco  that  he  is  a 
"slave   to   the  weed."     Just  so   we  could  say  of 
him  that  he  was  a  slave  to  books,  if  his  habit  was 
to  read.     It  has  been  truly  said  that  ' '  a  smirched 
youth  becomes  a  tainted  man."     A  grown  man  is 
slothful  because  in  his  youth  he  was  lazy,  and  an 
industrious  man  is  such  because  it  was  a  habit  in 
youth.     Therefore,  it  can  be  truthfully  said  that 
all    things,    cheerfulness,    happiness,    punctuality, 
industry,   truthfulness,   etc.,   are    things    of   habit. 
Let  this  thought  be  constantly  before  you  as  you 
proceed  in  making  for  yourself  a  name  and  reputa- 
tion in  the  medical  profession.     Avoid  all  things 
which  would  have  the  tendency  to   create  a  bad 
habit.     The  habit  which  will  profit  you  most  in 
the    medical    profession  is    that    of   concentration. 
With  the  young  this  is  nearly  an  impossibility,  but 
by  cultivation  it  can  be  assured.      It  can  be  gained 
only  by  strenuous  effort,  and  after  a  while  it  will  be 


THE  PRACTICE  OF  MEDICINE  1 5 

accomplished.  Fasten  your  mind  on  one  object 
and  keep  it  there,  and  most  any  problem  can  be 
solved  or  any  task  accomplished.  Think  of  what 
William  Wirt  wrote  concerning  Chief  Justice  John 
Marshall:  "Here  is  John  Marshall,  whose  mind 
seems  to  be  little  else  than  a  mountain  of  barren 
and  stupendous  rocks,  an  inexhaustible  quarry 
from  which  he  draws  his  materials  and  builds  his 
fabrics,  rude  and  Gothic,  but  of  such  strength  that 
neither  time  nor  force  can  beat  them  down  ;  a 
fellow  who  would  not  turn  off  a  single  step  from 
the  right  line  of  his  argument."  Try  and  let  it  be 
said  of  you  in  medicine  what  Wirt  said  of  this 
great  lawyer. 

Cheerfulness.  By  all  means  cultivate  a  cheerful 
disposition.  Neither  the  sick  or  the  well  like  the 
man  who  is  morose,  and  your  conduct  in  the  sick- 
room will  be  either  for  good  or  evil,  according  to 
your  disposition.  A  recent  writer  speaks  thus  of 
the  cheerfulness  of  doctors :  "A  reason  for  the 
cheerful  temperament  which  characterizes  so  many 
doctors  is  probably  to  be  found  in  the  type  of  man 
entering  the  medical  profession.  The  nervous, 
the  timid,  the  dyspeptic,  and  the  invalid  do  not 
readily  take  to  the  doctor's  calling.  It  demands 
too  much  energy,  fortitude,  and  capacity  for  human 
intercourse.  Only  those  endowed  with  strong  and 


l6  HOW  TO  SUCCEED  IN 

virile  temperaments  are  fitted  for  the  profession  or 
likely  to  embrace  it.  The  intensity  and  super- 
abundance of  this  initial  virility  is  powerfully  exem- 
plified in  medical  students,  who  are  not  notable  for 
the  repose  of  their  manners  or  the  gentleness  of 
their  instincts.  How  much  of  the  residuum  of  high 
animal  spirits  remains  in  matured  and  aged  mem- 
bers of  the  medical  fraternity  is  often  shown  at  the 
annual  functions  of  our  medical  societies,  in  which 
long-repressed  hilariousness  assumes  a  form  of 
uproariousness.  It  is  because  medical  men  are,  as 
a  class,  of  a  peculiar  virile  nature  that  they  are 
cheerful  and  resourceful." 

Courage.  If  any  calling  on  earth  demands 
positive  and  unequivocal  courage,  it  is  that  of  a 
doctor.  Moments  that  ' '  try  men's  souls  "  are  his, 
and  many  are  the  times  that  he  ' '  sweats  blood. " 
In  these  eventful  hours  there  is  absolutely  no  use 
for  the  man  without  courage.  The  human  body 
to  deal  with,  the  flight  of  a  soul  if  he  mistakes, 
family  ties  forever  sundered  by  a  slip  of  his  knife  ; 
the  maker  of  widows  and  orphans,  if  perchance  his 
calculations  of  a  dose  is  wrong;  the  home  rendered 
desolate  and  the  cry  of  the  bereaved,  if  his  diagno- 
sis has  failed  him.  I  say  that  it  requires  a  strong 
man  with  courage  to  fill  this  post.  "He  was 
courageous,  knowing  no  fear, "  must  be  said  of  you 


THE  PRACTICE  OF  MEDICINE  I/ 

also,  if  you  are  well  fitted  for  the  practice  of  the 
medical  profession. 

Patience.  To  exercise  patience  is  often  one  of  the 
most  difficult  of  all  things.  But  you  must  possess 
this  attribute  and  exercise  it  often  if  you  expect 
to  succeed  as  a  doctor.  Patience  in  waiting  for 
practice  ;  patient  in  the  execution  of  your  duties ; 
patience  in  listening  to  the  "tales  of  woe"  with 
which  you  are  beguiled  ;  patient,  waiting  with  con- 
fidence for  the  fruition  of  your  hopes. 

Manner.  Manner  has  much  to  do  with  the  suc- 
cess of  a  doctor.  It  was  said  of  an  eminent  physician 
who  did  a  very  large  practice  that  his  success  in  get- 
ting the  same  was  due  to  his  manner  in  the  sick-room. 
No  one  who  ever  watched  this  charming  man  on  his 
daily  rounds  doubted  but  that  there  was  much  truth 
in  the  assertion.  Suave,  kind,  and  gentle,  his  sooth- 
ing words  were  as  lullabys  to  the  sick ;  the  touch  of 
his  hand  was  inspiring,  and  his  gentle  smile  con- 
tagious. I  once  knew  a  sick  young  lady  to  refuse 
to  have  a  certain  doctor  enter  her  room  because  of 
his  • '  horse  laugh  "  on  the  porch.  A  distinguished 
educator  once  said  that  he  could  tell  whether  a 
man  was  a  gentleman  or  not  by  hearing  him  walk. 
It  must  be  remembered  that  it  is  the  physician's 
province  to  deal  with  the  sick,  not  with  the  well, 
and  the  same  manner  can  not  be  used  toward  both. 


18  HOW  TO  SUCCEED  IN 

Illness  is  naturally  accompanied  by  fear,  and  it  is 
one  duty  of  the  medical  attendant  to  quiet  or  elimi- 
nate this  feeling,  for  it  is  a  great  factor  in  disease. 
This  can  not  be  done  in  a  brusque  manner.  True, 
that  many  conditions  must  be  dealt  with  and  in  a 
very  positive  way,  but  this  can  be  done  without 
being  rude.  The  doctor  is  fortunate  who  possesses 
a  pleasant  tone  of  voice,  for  it  is  a  wonderful  thing 
in  its  manipulation;  one  can  be  soothed  and  com- 
forted by  such,  when  a  rasping  and  harsh  voice 
would  irritate  and  depress.  It  would  be  well  worth 
your  while  to  cultivate  this  attribute  if  you  have 
it  not.  Loud  and  boisterous  talk  is  no  more  to  be 
tolerated  in  the  sick-room  than  the  making  of  dis- 
cordant sounds  by  the  use  of  instruments  out  of 
tune.  Laughter  is  contagious,  and  in  its  place  is 
much  to  be  desired,  for  it  dissipates  melancholy; 
but  the  sick-chamber  is  not  the  place  to  exercise  it, 
for  it  grates  harshly  upon  the  ear  of  the  invalid. 
A  pleasing  joke  told  in  a  proper  way  at  a  suitable 
time  is,  and  should  be,  appreciated,  but  it  must  not 
be  forgotten  that  those  cast  down  by  sickness  fail 
to  appreciate  the  telling  of  the  same.  I  have 
known  doctors  who  seemed  to  think  that  to  each 
sick  person  to  whom  they  were  called  they  must 
tell  some  unseemly  joke,  better  suited  to  the  street 
corner  than  told  to  one  distressed.  You  must 


THE  PRACTICE  OF  MEDICINE  1$ 

inspire  the  patient  with  your  very  presence;  there- 
fore, a  certain  dignity  must  be  observed.  Gentle- 
ness, kindness,  and  the  necessary  amount  of  sym- 
pathy never  go  amiss  in  the  sick-room.  If  a  per- 
son is  sick  enough  to  call  a  doctor  the  fear  of  death 
usually  confronts  him.  This  fear  can  not  be  laughed 
away,  nor  is  it  the  time  or  place  for  a  witticism.  Be 
firm,  but  kind;  dignified,  not  haughty;  sympathetic, 
not  effusive.  Temper  wisdom  with  discreetness, 
and  let  your  manner  always  be  that  of  a  gentle- 
man, whether  it  be  in  or  out  of  the  sick-room.  You 
must  have  conscious  power  in  order  to  deal  with 
the  sick.  This  power  is  said  to  be  the  eloquence 
of  action.  By  possessing  it  you  will  master  your 
profession  and  control  your  patients.  It  destroys 
all  fear  and  incites  you  to  action.  Do  not  fail  to 
cultivate  this  power,  for  without  it  you  will  remain 
in  a  quiescent  state,  and  never  progress.  If  at  any 
time  you  feel  creeping  over  you  a  fear,  trample  it 
under  your  feet  and  assert  your  independence  by 
asserting  this  power.  A  great  deal  of  fun  has  been 
poked  at  the  man  who  is  "big-headed,"  but  I 
always  admire  the  young  man  who  holds  his  head 
high  and  has  self-esteem.  It  keeps  him  out  of  the 
mire  and  gives  him  a  proper  estimate  of  himself. 
Let,  however,  your  dealings  with  people  be  simple 
and  not  ostentatious.  Never  give  the  impression 


2O  HOW  TO  SUCCEED  IN 

that  you  feel  yourself  better  or  above  your  fellow- 
men  in  any  particular. 

The  most  disgusting  of  all  things  is  to  see  a 
little-excuse-of-a-man  strutting  and  pawing  the 
earth,  all  fuss  and  feathers,  but  of  no  intellectual 
attainment.  In  your  commingling  with  the  sick  let 
your  conversation  be  pure,  not  puritanical;  your 
conduct  above  reproach,  your  motives  not  sinis- 
ter, and  your  actions  and  purposes,  even  to  the 
patient  who  is  a  stranger  to  you,  be  as  to  one  of 
your  own  blood.  ' '  Do  unto  others  as  you  would 
have  them  do  unto  you. "  In  this  day  of  ' '  reason, " 
when  the  mind  of  man  is  so  harassed,  doubtful, 
and  unsettled  concerning  a  future  existence,  let  me 
suggest  that  you  do  not  intrude  upon  the  sanctity 
of  the  sick -chamber  any  expression  for  the  purpose 
of  unsettling  a  rooted  faith.  Much  better  is  it  to 
fear  God  and  love  your  fellow-man,  for  this  is 
righteousness  indeed.  Therefore,  to  sum  up,  we 
have  a  man  who  is  educated  (college  preferred) ; 
of  unblemished  character,  who  is  honest  and  just; 
is  generous  and  humble;  has  decision  of  purpose; 
is  persevering  and  ambitious;  has  the  courage  of 
his  convictions,  and  is  patient  for  results;  has  the 
manner  of  the  true  gentleman  and  the  personal 
appearance  to  command  respect;  who  is  clean  in 
both  mind  and  body.  Such  a  man  must  and  will 


THE  PRACTICE  OF  MEDICINE  21 

succeed  in  the  practice  of  medicine,  or  indeed  in 
any  calling  that  he  might  select. 

Diplomacy.  It  is  not  only  to  ' '  affairs  of  State  " 
that  diplomacy  applies,  but  to  ' '  affairs  "  of  every- 
day life  as  well.  To  ' '  handle  "  people  is  a  great 
accomplishment;  some  are  "  hard-headed, "  others 
timid;  some  unsuspecting,  others  suspecting.  A 
harsh  expression  is  necessary  to  control  some;  to 
others  it  would  be  a  cruel  blow.  You  must  learn 
to  study  the  case  before  giving  an  opinion.  Above 
all,  be  a  good  listener;  this  will  enable  you  to  judge 
of  all  the  small  or  concealed  parts  of  each  history, 
and  in  it  you  may  find  the  key  which  will  unlock 
the  mystery.  Much  depends  upon  diplomacy  in 
aiding  you  to  judge  fairly  and  to  diagnosticate  the 
case  properly.  Upon  it  may  depend  knowledge, 
secrecy,  honor,  wealth,  sobriety,  and  even  the  marital 
relation.  Remember  that  you  are  the  one  to  whom 
confessions  are  made;  it  will  require  much  diplo- 
matic action  on  your  part  to  keep  secret  what  is 
told  you.  It  does  not  imply  in  the  least  that  deceit 
is  necessary  to  comply  with  the  demands  of  diplo- 
macy. It  is  said  of  Mr.  McKinley,  the  martyred 
president,  that  he  was,  while  living,  the  greatest 
diplomat  of  them  all,  and  yet  he  never  was  accused 
of  being  deceitful.  Make  yourself  familiar  with 
every  phase  of  the  case,  and  ascertain  in  a  diplo- 


22  HOW  TO  SUCCEED 

matic  way  everything  that  bears  on  it,  but  in  so 
doing  ' '  let  not  your  right  hand  know  what  your 
left  hand  doeth."  It  is  a  notorious  fact  that  men, 
and  women  too,  who  come  to  you  for  advice  and 
treatment  will  often  conceal  the  most  important 
things  from  you,  and  without  such  knowledge 
neither  your  advice  or  treatment  would  avail  any- 
thing. Be  cautious  and  diplomatic  in  ascertaining 
this  information.  In  your  conduct  with  men,  in 
your  questions  to  the  patient,  and  in  the  man- 
agement of  your  cases  be  a  diplomat. 


CHAPTER  II 

LOCATION 

Naturally  the  first  thought  entertained  by  the 
young  man  after  graduating  from  a  medical  col- 
lege is  the  one  of  locating  in  the  proper  place  to 
practice  his  profession.  I  know  of  no  more  mo- 
mentous question,  for  its  decision  carries  with  it 
the  selection  of  his  future — possibly  permanent — 
home,  where  not  only  his  reputation  is  to  be 
made,  but  where  the  joys  of  a  household  are  to 
be  shared  for  life;  therefore  this  question  should 
not  be  decided  in  haste,  nor  should  a  location  be 
selected  on  mere  hearsay.  The  place  should  be 
visited  and  a  careful,  searching  investigation  be 
made.  There  are  many  things  to  be  considered  in 
making  a  selection. 

First,  is  it  a  place  in  which  you  would  be  willing 
to  live  out  your  days  ?  Young  doctors  often  reason 
with  themselves  thus :  ' '  True,  this  is  a  poor  coun- 
try, the  society  is  not  good,  no  special  advantages, 
but  I  will  locate  here  for  the  first  few  years  until  I 
get  some  experience;  then  I  will  move  to  a  larger 
field."  This  kind  of  reasoning  is  mere  folly,  and 
will  prove  most  disappointing.  In  the  first  place, 
you  should  not  expect  to  experiment  upon  the  poor. 


24  HOW  TO  SUCCEED  IN 

If  you  have  not  the  necessary  knowledge  and  expe- 
rience to  practice  medicine,  you  should  obtain  it 
before  attempting  to  "try  it"  anywhere,  be  it  a 
poor  or  rich  locality.  The  schools  of  to-day  are 
so  well  equipped  that  if  you  remain  long  enough 
and  study  hard  enough  you  will  have,  in  addition 
to  other  things,  a  bedside  experience  that  will  qualify 
you  to  at  once  enter  into  practice.  Until  you  feel 
that  you  have  already  experience,  do  not  locate  in 
the  practice  anywhere.  Life  is  too  sacred  a  thing 
for  you  to  trifle  with,  and  be  sure  that  you  are 
qualified  before  you  begin. 

Second,  hundreds  before  you  have  made  the 
same  resolution  in  regard  to  moving  ' '  after  a  while, " 
but  a  survey  will  show  that  the  vast  majority  never 
do.  They  live  and  die  in  the  place  of  their  first 
selection.  The  reason  is  obvious:  Family  ties  are 
established,  friendships  cemented,  property  accu- 
mulations arise,  accounts  scattered,  etc. ,  are  reasons 
sufficient  to  deter  one  from  a  hazardous  move,  hence 
well  enough  is  left  alone  and  the  battle  of  life  is 
fought  out  at  the  place  of  enlistment.  There  is  an 
exception  to  this  in  the  young  doctor  who  changes 
his  location  several  times  before  becoming  perma- 
nently settled.  This  is  very  discomforting,  and  if 
the  advice  is  heeded  that  is  given  in  these  pages  it 
will  be  unnecessary.  You  will  permit  me,  then,  to 


THE  PRACTICE  OF  MEDICINE  2$ 

help  you  decide,  or  rather  select  a  location.  We  are 
to  presume  that  you  visit  the  place  recommended; 
it  has  been  told  you  that  it  is  a  first-class  location 
because  ' '  there  are  no  other  doctors  there,  no,  not 
within  miles  of  it. "  How  preposterous,  how  absurd; 
why,  it  is  an  insult  to  your  intelligence  to  hint  such 
a  reason.  Are  you  afraid  of  honest  competition? 
If  so,  you  had  better  go  back  to  school.  Would  you 
be  willing  to  live  in  a  country  in  this  day  of  many 
doctors  that  was  too  poor  to  enlist  the  attention 
of  some  poor  young  fellow  looking  for  a  location? 
Why,  the  proceeds  of  a  year's  practice  would  not 
buy  you  a  decent  coat.  And,  too,  do  you  not  want 
the  companionship  and  the  help  in  time  of  need  of 
some  good,  kind  brother  in  the  profession?  Put 
behind  you  all  such  reasons  as  this,  and  go  forth 
to  make  your  own  selection.  Being  on  the  ground, 
there  are  numerous  things  to  be  determined.  What 
is  the  price  of  ground  per  acre?  This  has  a  great 
bearing  on  your  future  prospects  in  a  financial  way. 
And  here  let  me  say  in  parenthesis,  this  part  of 
your  professional  career  is  not  to  be  ignored,  for 
have  you  not  a  wife  and  mayhap  children  to  sup- 
port? Even  if  you  have  not,  your  pride  should  be 
such  as  to  compel  you  to  dress  and  live  well  your- 
self, and  it  takes  money  to  do  it.  We  will  decide 
in  favor  of  the  land  if  it  is  a  fertile  soil  and  com- 


26  HOW  TO  SUCCEED  IN 

mands  a  good  price.  Next,  what  kind  of  society 
is  this  that  I  am  to  bring  my  wife  into  and  throw 
around  my  children  in  their  every-day  association? 
No  getting  around  the  fact  that  you  are  to  "judge 
a  man  by  the  company  he  keeps,"  and  that  envi- 
ronment is  the  one  great  factor  in  molding  the 
young  life.  You  are  about  to  decide  a  question 
here  that  may  mean  a  life  full  of  sorrow  to  you; 
you  are  assuming  a  duty  for  those  who  are  too 
young  to  know  of  responsibility,  that  are  near  and 
dear  to  you,  and  in  the  event  of  a  mistake  made  by 
you  may  rise  up  and  curse  you.  Look  well,  then, 
to  the  character  of  people  who  are  to  become  your 
daily  associates  and  the  companions  of  your  chil- 
dren. Let  us  inquire  into  the  school  facilities,  the 
common  school,  and  the  disbursement  of  the  com- 
mon school  fund.  There  is  no  one  thing  that  be- 
tokens the  intelligence  of  a  community  so  decidedly 
as  the  existence  of  good  schools.  Go  into  any  town, 
and  if  the  boast  is  made  of  fine  colleges  and  schools 
of  good  repute,  there  you  will  find  people  of  refine- 
ment and  culture.  What  a  wonderful  incentive  it 
would  be  for  a  professional  man  to  locate  there. 

Well,  we  have  found  good  soil  and  first-class 
schools.  I  trust  that  there  may  be  a  college  in  the 
outskirts  that  we  failed  to  see.  I  heard  a  gentle- 
man remark  once  that  you  could  judge  a  community 


THE  PRACTICE  OF  MEDICINE  2/ 

by  the  kind  of  cemetery  they  kept.  Let  us  look  at 
this  home  for  the  dead.  Here,  under  its  shade 
trees,  your  body  may  be  laid  to  rest  and  those  of 
your  children  and  your  wife.  Wife!  what  a  hal- 
lowed name!  After  you  have  finished  your  life's 
work  and  are  waiting  for  the  final  summons,  you 
look  back  over  the  past  and  call  her  name  blessed! 
Who  was  it  that  started  with  you  in  your  profes- 
sional career  and  promised  at  the  altar  to  share 
life's  burdens  with  you?  Who  was  it  that  during 
the  long  and  dreary  days  of  waiting  for  practice 
cheered  you,  and  showed  not  that  she  too  was 
anxious?  Who  was  it  in  the  dark  days,  when  you 
wondered  if  troubles  would  never  cease,  consoled 
you  while  tears  of  disappointment  ran  down  her 
cheeks  ?  Who  was  it,  whether  in  poverty  or  riches, 
sorrow  or  gladness,  affliction  or  health,  sunshine  or 
storm,  adversity  or  prosperity,  slander  or  praise, 
was  always  your  silent  but  perfect  "partner"? 
Your  wife.  Who  cared  for  the  household  while 
you  cared  for  the  sick;  who  watched  long  into  the 
night  for  your  safe  return  while  the  storm  raged 
without?  Who  saved  here  and  economized  there 
that  you  might  not  feel  the  touch  of  want;  who 
risked  health  and  the  comforts  of  life  that  you 
might  be  happy  and  free  from  care?  Your  wife. 
It  is  she  that  will  rest  by  your  side  in  this  mound 


28  HOW  TO  SUCCEED  IN 

of  earth  after  the  curtain  has  fallen  over  her  grave. 
Let  the  green  grass  wave,  the  stars  sparkle  and 
twinkle  all  the  night  long;  the  birds  sing  their 
sweetest  carols  and  lullabys,  the  brook  go  dancing 
by  on  its  way  singing  its  murmuring  song,  and  the 
night  winds  whisper  their  softest  benedictions.  She 
was  faithful  and  true,  even  if  the  whole  world  proved 
false.  Peace  to  her  ashes!  Before  quitting  the 
place  it  would  be  well  to  ask  concerning  the 
churches.  It  may  be  that  during  the  busy  life  that 
you  are  to  lead  your  thoughts  may  not  drift  into 
these  channels,  but  think,  at  least,  of  the  "little 
woman  "  and  the  children.  I  dare  say  that  in  this 
place  of  schools,  society,  and  thrift  you  will  find 
that  the  good  people  do  not  neglect  assembling 
themselves  together  to  render  thanks  to  the  giver 
of  all  perfect  gifts. 

So,  I  take  it,  that  in  this  community  you  can 
"locate."  Do  not,  I  beg  of  you,  do  so  with  any  idea 
of  ' '  moving  to  a  larger  field  after  a  while. "  Such 
a  place  as  has  been  described  is  likely  known  as  a 
country  ' '  village  "or  "  town. "  It  may  be  that  you 
have  aspirations  to  be  a  "city  doctor."  Well 
enough  and  good,  but  let  me  beseech  you  to  give 
the  subject  long  and  careful  consideration  before 
making  the  move.  If  after  this  you  so  conclude, 
the  suggestions  herein  given  may  fit  as  well.  Will 


THE  PRACTICE  OF  MEDICINE  29 

you  permit  a  few  personal  reflections  from  one  who 
has  tried  both  ?  The  young  man  who  selects  a  city 
for  his  labors  in  the  medical  profession  usually  has 
a  most  difficult  time  of  it  for  the  first  few  years. 
This  is  especially  true  if  he  is  handicapped  by  the 
want  of  funds.  You  must  consider  that  the  cost  of 
living  is  much  greater  than  in  a  smaller  place;  it  is 
necessary  that  more  money  be  expended  in  an 
office,  etc.,  and  the  feeling  will  often  creep  over 
you  that  more  attention  is  given  to  your  competitor, 
who  has  money,  than  to  you.  The  competition  and 
rivalry  are  much  greater,  and,  at  last,  it  is  only  a 
comparative  few  who  succeed  to  a  large  practice  in 
a  city.  I  have  often  been  moved  to  a  sense  of 
compassion  for  the  scores  of  young  men  who  were 
merely  eking  out  an  existence  in  the  large  cities. 
True,  that  if  you  are  possessed  of  wealth,  are 
influential,  or  have  friends  who  are,  with  energy  and 
pluck  you  will  succeed,  after  a  while,  no  matter 
where  you  may  locate.  In  the  country  things  seem 
different ;  the  doctor  is  the  leading  citizen ;  he 
numbers  his  friends  by  the  score,  and  there  is 
a  freedom  from  care  and  great  responsibility 
which  constantly  beset  his  city  brother.  You  may 
say  that  a  restricted  field  will  not  give  you  the 
opportunity  you  crave  to  gratify  your  ambition. 
Think  of  Ephraim  McDowell,  who  did  his  great 


3O  HOW  TO  SUCCEED  IN 

work  in  a  small  country  town,  whose  name  to-day 
is  quoted  by  every  writer  on  surgery  throughout 
the  world.  And,  at  last,  what  is  ambition  ?  Is  it 
not  enough  to  relieve  physical  suffering ;  to  quiet 
the  minds  that  are  disturbed  ;  to  do  up  broken 
limbs ;  to  care  for  woman  as  she  goes  through  the 
throes  of  childbirth  ;  to  minister  to  the  infant  in 
arms  ;  to  soothe  the  dying  ?  I  say,  is  this  not  am- 
bition enough?  More  than  this  will  carry  you  into 
streams  of  trouble  and  sorrow  too  deep,  often,  for 
you  to  extricate  yourself.  It  will  teach  you  that 
"all  that  glitters  is  not  gold";  that  people  and 
things  are  often  not  what  they  seem  ;  that  friend- 
ship is  often  but  a  name,  and  that  after  you  have 
reached  the  very  pinnacle  of  fame  you  will  cry  out, 
' 'All  is  vanity! "  Compare  this  to  the  restful  repose 
of  life  in  the  country.  It  has  been  said  that  ' '  God 
made  the  country,  man  the  city."  Think  of  com- 
muning with  nature  every  day  ;  the  tall  oaks  ;  the 
green  grass  ;  the  babbling  brooks.  In  lieu  of  the 
odors  from  sewers,  factories,  and  mills,  you  have 
that  from  new-mown  hay,  the  honeysuckle,  and 
the  thousand  wild  flowers  that  bloom  on  hill-side 
and  in  the  valley.  The  country  doctor  :  his  name 
is  a  synonym  of  goodness  and  charity.  Long  after 
he  has  gone  to  rest  will  pleasant  memories  follow 
him.  As  I  drift  back  in  thought  to  my  childhood 


THE  PRACTICE  OF  MEDICINE  3! 

days,  I  can  see  an  illustrious  example  of  this  good 
old  country  doctor.  Of  rugged  frame  and  face 
marked  with  care;  of  stern  appearance,  yet  kind 
to  a  fault;  who  faced  the  elements,  be  it  storm  or 
sunshine,  daytime  or  nighttime,  to  serve  the  poor 
as  well  as  the  rich.  Not  college  bred,  'tis  true,  but 
possessed  of  that  faculty  that  makes  men  great 
indeed — good,  hard,  common  sense.  Its  worth 
can  not  be  overestimated  and  a  substitute  is  of  no 
avail.  This  man,  aged  by  sympathy  and  unrest, 
caring  more  for  the  people  than  for  self,  working 
day  in  and  day  out  for  humanity's  sake — what  a 
wonderful  tale  he  could  tell  after  threescore  years 
and  ten.  He  is  an  honor  to  any  country  and  an 
example  to  any  man —  this  country  doctor.  So  I 
say,  take  your  choice  and  we  will  prepare  for  actual 
work. 

Home.  The  parting  from  the  old  home  is  thus 
beautifully  described  by  Elvira  Sydnor  Miller: 

One  of  the  saddest  hours  in  one's  life  is  that  in  which 
we  part  from  a  home  that  has  been  a  scene  of  our  sweetest 
and  dearest  joys.  Every  brick  in  the  old  house  is  sacred 
to  us,  every  tree  that  casts  its  soft,  green  shadows  over  the 
doorway,  every  flower  whose  blossoms  star  the  air  with 
the  glory  of  color.  Beneath  its  sacred  roof-tree  those 
whom  we  have  loved  passed  away  into  the  silence.  There 
joy  and  grief  have  abided  with  us,  and  the  years,  bright 
with  sunshine  and  dark  with  shadows,  have  sped  onward 
in  their  flight.  When  a  man  builds  a  home  for  those  he 


32  HOW  TO  SUCCEED  IN 

loves  he  puts  something  more  than  mere  bricks  and  mortar 
into  the  building;  his  hopes,  his  dreams,  his  aspirations, 
his  tenderness  of  heart,  are  incorporated  with  the  structure. 
He  rears  a  home  for  his  loved  ones,  even  as  the  birds  of 
the  air  build  their  fragile  nests,  and  like  them,  the  storms 
and  wintry  weather  of  life  tear  down  and  destroy  the  habi- 
tation built  with  hands.  An  old  home  represents  a  lifetime 
to  us.  We  see  the  sunset  gilding  its  roof  and  firing  its 
western  windows,  the  flowers  about  it  asleep  in  the  light, 
the  trees  standing  silent  and  somber  in  the  evening  glow, 
and  a  thousand  recollections  of  past  days  throng  upon  us 
and  wake  the  tears  until  we  look  back  upon  the  paradise 
we  are  leaving  through  a  mist  of  sadness,  even  as  Eve 
upon  the  glowing  blossoms  and  golden  skies  of  her  lost 
Eden.  One  can  dream,  perhaps,  that  Lucifer  himself, 
the  star  of  the  morning,  must  have  gazed,  homesick  and 
heartsick,  upon  the  gleamy  outlines  of  that  starry  heaven 
whose  shining  ways  he  was  to  tread  no  more. 

Having  now  determined  to  cast  your  lot  with 
these  people  in  the  delightful  country  town,  the 
next  thing  in  order  is  to  select  a  home.  Home ! 
What  a  hallowed  term.  I  have  no  doubt  but  that 
as  you  lisp  it  on  your  tongue  your  thoughts  go  back 
to  the  place  where  you  were  born.  You  can 
scarcely  realize  that  it  is  to  be  no  longer  your  home. 
For  years  to  come  your  thoughts  will  travel  back 
to  this  dear  old  place,  and  you  will  tell  to  your 
children,  yea,  and  your  grandchildren,  the  stories 
of  your  youth,  and  recite  to  them,  with  tear-stained 
face,  the  sweet  memories  of  your  childhood  home. 


The  little  wagon  winds  its  way  down  the  hill  to  the  vine-clad  cottage. 

\Page  34] 


THE  PRACTICE  OF  MEDICINE  33 

Every  hill-side,  every  valley  is  sacred  to  you  ;  the 
old  pump,  the  pond,  the  cellar  door,  the  trees,  the 
lowing  of  the  cows  coming  home,  all  bring  back  to 
you  days  that  must  now  be  forgot.  Yet,  awhile, 
you  remember  the  gray-haired  mother  who  nursed 
you  through  sickness  and  cheered  you  always,  who 
bade  you  be  a  good  boy  when  you  started  out  from 
her  to  face  the  world,  and  the  stern  old  man  who, 
it  is  true,  grumbled  a  bit  because  of  the  little  extras 
that  you  would  heap  up  at  college  ;  but,  bless  his 
soul,  how  proud  he  is  to-day  of  his  doctor  son. 
Time  will  never,  and  should  never,  efface  these 
from  your  memory. 

You  are  to  select  a  home.  Shall  it  be  in  a  board- 
ing house  or  a  cottage  ?  By  all  means  the  latter. 
Why,  if  you  are  boarding  in  a  house  it  is  their  home, 
not  yours.  Not  a  thing  can  you  call  your  own  —  an 
ax,  a  hoe,  a  chair,  or  a  table.  You  will  never  feel 
that  exhilaration  of  independence  that  comes  to  a 
man  who  can  say  "I  own  this  and  that."  Oh,  no; 
you  may  not  own  your  house  at  first,  but  you  can 
call  it  home,  for  in  and  around  it  are  the  things 
that  constitute  one's  abiding  place.  The  barking 
of  the  dog,  the  mewing  of  the  cat,  the  creaking  of 
the  old  arm-chair,  and  the  cooing  of  the  doves  in 
the  trees,  all  sound  so  different  than  when  fettered, 
as  it  were,  in  the  home  of  others. 


34  HOW  TO  SUCCEED  IN 

Again  :  you  want  your  children  to  have  the  free- 
dom  that  should  be  guaranteed  to  youth,  and  the 
implanting  within  them  that  love  of  home  which 
has  solaced  you  for  so  many  years.  Let  it,  then,  be 
a  house  of  your  own,  or  at  least  that  you  will  control, 
that  you  will  make  your  habitat.  It  need  not  be 
pretentious — say  five  rooms — a  sitting  room,  a  bed 
room,  a  dining  room,  a  kitchen,  and  a  guest's 
chamber.  Don't  forget  the  last-named,  for  don't 
you  know  that  the  ' '  Governor  "  and  the  good  old 
mother  are  to  come  often  to  see  you  ?  I  imagine 
that  I  see  them  now  as  the  little  wagon  winds  its 
way  down  the  hill  to  the  vine-clad  cottage,  the  first 
visit  to  the  ' '  doctor  "  and  his  wife.  The  thoughts 
that  fill  their  bosoms  we  will  not  attempt  to  pene- 
trate. Their  arrival  is  marked  by  the  barking  of 
the  dog  and  the  hustling  of  the  children,  or  per- 
haps it  is  only  one  little  blue-eyed  babe  that  is  to 
welcome  them,  and  they  have  come  to  its  christen- 
ing. No  trunks  are  lifted  out  of  the  wagon,  but 
bundle  after  bundle ;  one  is  very  heavy,  and  its  con- 
tents can  not  be  misjudged,  for  the  flavor  of  old 
sugar-cured  ham  can  not  be  concealed  by  the  bag; 
and  cans  containing  all  kinds  of  fruits  put  up  by 
those  dear  hands  that  coddled  you  when  a  babe, 
and  a  jar  of  honey,  "home-made  honey";  for  did 
not  the  very  bees  that  so  often  in  the  past  make 


THE  PRACTICE  OF  MEDICINE  35 

you  afraid  manufacture  it  and  send  it  as  a  peace- 
offering  for  the  many  times  that  they  have  fright- 
ened, perhaps  stung  you?  It  has  been  said  by 
the  old  folks  before  starting,  ' '  Let's  take  these  few 
things  along  with  us ;  it  is  not  much,  but  it  will 
help  the  young  folks  along  a  little." 

Yes,  your  good  old  mother  and  father  will  come 
often  to  see  you,  and  so  will  your  wife's  father  and 
mother — your  mother-in-law.  How  many  cruel 
jokes  have  been  perpetrated  in  her  name,  ' '  mother- 
in-law."  Think  of  the  man  who,  when  telegraphed 
to  that  his  mother-in-law  was  dead,  and  was  asked 
if  they  should  embalm  or  cremate  the  body, 
replied  ' '  Do  both,  and  take  no  chances. "  It  is  well 
that  all  allusions  to  the  mother-in-law,  that  do  not 
carry  credit  with  them,  are  understood  to  be  in  jest. 
Her  place  can  never  be  supplied  by  any  save  the 
real  mother.  In  sickness  she  awaits  no  summons, 
but  rushes  to  your  bedside  ;  she  takes  care  of  your 
children,  and  bears  the  hardships  which  such 
service  entails  and  counts  it  a  pleasure.  Her 
touch  is  the  most  delicate,  her  voice  the  sweetest, 
her  footstep  the  lightest  of  all,  save  the  real  mother. 
She  helps  bear  your  burdens,  smooths  your  path- 
way, and  loves  you  as  her  own.  All  honor  to  her 
name,  and  may  her  last  days  be  free  from  care. 
Yes,  your  mother-in-law  will  come  to  see  you. 


36  HOW  TO  SUCCEED  IN 

If  it  happens,  and  it  is  sure  to  do  so,  that  the 
time  ever  comes  that  because  of  age  or  infirmity 
these  dear  parents  can  not  come  to  you,  do  not 
neglect  the  opportunity  to  go  often  to  them.  The 
day  is  not  far  distant  when  you  will  receive  a  sum- 
mons to  come  in  haste,  and  even  then  it  may  be 
too  late.  The  heart  that  loved  you  so  is  now  still, 
and  the  busy  hands  that  cared  for  you  when  you 
could  not  care  for  yourself  are  now  at  rest.  No 
greeting,  no  clasping  you  to  the  dear  old  bosom ; 
and  many  years  will  be  spent  by  you  in  sorrow  and 
remorse  if  you  have  allowed  business  or  pleasure 
to  prevent  you  from  going  often  to  see  them  when 
they  could  not  come  to  see  you.  Do  not  forget  or 
neglect  the  ' '  old  folks. " 

Yes,  you  must  have  a  guest's  room.  No  home 
should  be  so  reserved  as  not  to  be  glad  to  admit  an 
old  friend  or  the  stranger  within  its  gates.  Perhaps 
you  will  have  noticed  that  I  have  neglected  or 
forgotten  to  include  a  ' '  parlor  "  in  the  list  of  rooms. 
No,  not  forgotten ;  but  of  all  useless  things  to  a 
hospitable  home  is  a  so-called  parlor.  Did  you 
never  pay  a  call  during  the  week-days  to  a  friend's 
house  in  the  country  and  be  ushered  into  the 
' '  parlor  "  on  a  cold  winter's  day  ?  Even  the  thought 
of  it  is  chilling.  No  fire  ;  the  window  blinds,  which 
have  been  closed  since  the  first  frost,  render  the  room 


THE  PRACTICE  OF  MEDICINE  37 

utterly  dark.  Groping  around,  you  are  apt  to  over- 
turn a  chair  or  table,  and  while  waiting  for  the 
friend  to  make  his  appearance  you  walk  around 
inspecting  whatever  can  be  seen  by  the  ray  of  light 
that  is  trying,  like  an  intruding  thing,  to  enter  the 
room  through  closed  blinds  and  shutters.  Here  on 
a  marble-top  table  is  an  oval  glass  cover  which  rests 
on  a  black  walnut  or  black-painted  base  (the  same 
material  of  which  cheap  coffins  are  made),  covering 
what  is  supposed  to  be  an  imitation  (in  wax)  of 
some  variety  of  familiar  fruit.  Don't  attempt  to 
guess  what  variety,  for  you  might  mistake  a  peach 
for  a  pear,  or  vice  versa.  On  the  wall  hangs 
another  glass  case,  somewhat  smaller  but  of 
the  same  design.  This  contains  some  hair,  dark 
or  blonde,  done  up  in  fantastic  design,  and  you  are 
reminded  that  it  belonged  to  dear  ' '  Aramintha, " 
who  departed  this  life  some  forty  years  ago.  In 
another  case  or  home-made  frame  is  an  inscription 
' '  worked  by  my  own  hands, "  or  possibly  by 
' '  Aramintha's  "  before  she  took  her  departure.  It 
reads,  ' '  What  is  home  without  a  mother?  "  Before 
you  have  time  to  make  further  inspection  the  friend 
arrives  and  you  are  ushered  into  the  opposite  — 
family  room,  where  a  great,  hot,  log  wood  fire  awaits 
you,  when  you  proceed  to  ' '  thaw  out. "  A  few 
years  ago  a  distinguished  teacher  and  good  doctor 


$8  HOW  TO  SUCCEED  IN 

friend  of  mine  died  from  having  pneumonia,  the 
result  of  waiting  in  one  of  these  ' '  vaults, "  called 
parlors,  until  the  patient  was  ready  to  ' '  see  him. " 
Do  you  blame  me  for  being  prejudiced  against  all 
such?  No;  don't  let's  have  a  parlor,  but  instead 
a  '  *  sitting  room  "  where  every  one  is  welcome. 

Being  now  ensconced  in  your  home,  it  will  be 
necessary  to  ' '  look  around  "  for  an  office. 

THE  OFFICE. 

Of  course  the  little  wife  will  urge  upon  you  to 
take  the  ' '  front  room  "  of  the  cottage.  Bless  her 
soul,  she  does  it  because  she  knows  it  to  be  the  best 
room,  and,  too,  to  save  expense.  But  don't  you  do 
it,  not  to  be  obstinate,  of  course,  but  she  knows 
not  what  she  doeth;  she  will  soon  realize  from 
what  you  have  saved  her.  Old  Jim  Smith  stops  in 
a  while  after  supper,  just  to  have  a  chat  and  talk 
about  his  ' '  rheumatiz. "  Besides  spitting  tobacco 
juice  over  the  floor,  he  will  think  it  disrespectful  to 
leave  before  bedtime.  Dinner  being  announced, 
Jack  Jones  will  go  into  same,  "bein'"as  he  is  "on 
the  ground."  Mrs.  Merrygoround  steps  in  to  see 
* '  Doc. , "  but  as  it  happens  that  he  is  not  in,  she  takes 
a  seat  and  for  a  few  hours  beguiles  the  wife  with 
the  family  afflictions.  It  would  not  take  many 
months  of  this  to  convince  the  little  woman  that  it 


THE  PRACTICE  OF  MEDICINE  39 

was  best  not  to  have  the  office  "in  the  house." 
If  at  all  possible  secure  an  office  easy  of  access 
and  having  two  rooms.  Don't  be  persuaded,  or 
persuade  yourself,  that  any  ' '  old  thing  "  will  do,  for 
it  will  not.  If  you  can  not  find  an  office  on  the 
ground  floor,  take  some  rooms  that  are  ' '  up-stairs. " 

It  has  always  been  a  thing  of  wonder  to  me  why 
a  man  who  insists  upon  having  everything  arranged 
with  precision  and  to  a  nicety  at  his  residence 
should  be  content  to  put  up  with  filth  and  disorder 
at  the  place  he  calls  his  office.  Many  times  I  have 
gone  into  such  places  and  it  was  with  difficulty  that 
a  decent  seat  could  be  found.  A  saddle  and  bridle 
here,  a  broken  stool  and  a  worse  chair  there,  a 
room  that  had  not  been  swept  for  ages  and  window 
panes  that  had  never  been  washed,  tobacco  juice 
and  cigar  stumps  ad  nauseam,  and  a  stove  that  had 
never  become  acquainted  with  a  polish.  And  in 
this  place  he  would  receive,  examine,  and  prescribe 
for  women  of  refinement  and  culture.  Wonder  it 
is  that  he  ever  had  a  patient,  but — well,  it  was  just 
as  good  as  the  other  doctors  had. 

Do  not  begin  your  professional  career  in  any  such 
manner.  You  owe  it  to  yourself,  your  wife,  and  the 
community  to  surround  yourself  with  more  attract- 
ive quarters  in  which  to  receive  your  patients.  Two 
rooms  it  must  be — one  a  reception  room,  the  other 


40  HOW  TO  SUCCEED  IN 

for  privacy  and  examinations.  The  bare  rooms 
will  not  suffice,  so  call  in  consultation  the  "silent 
partner, "  and  she  will  give  you  most  valuable  sug- 
gestions. The  place  must  be  furnished  and  deco- 
rated, and  who  can  do  this  so  well  as  the  wife? 
Man  is  able  to  cope  with  the  world  and  fight  the 
strong  battle  of  life ;  woman,  by  her  intuitive  knowl- 
edge, will  save  him  from  many  an  attack  and  help 
him  win  the  fight.  Man  will  amass  fortunes  by 
conquering  all  obstacles  that  may  come  in  his  way; 
woman  will  teach  him  how  to  retain  them.  Man 
will  perform  the  most  difficult  of  surgical  opera- 
tions, woman  will  add  the  condolence  and  sympathy 
that  will  insure  a  perfect  result.  You  may  furnish 
the  rooms  necessary  to  your  work,  but  the  wife 
must  add  the  touches  that  will  make  it  not  only 
habitable  but  pleasing.  A  carpet  must  be  bought, 
and  some  linoleum  or  matting;  the  walls  must  be 
papered;  some  window  shades,  a  rug,  perhaps,  a 
few  chairs,  and  a  picture  purchased;  a  little  deco- 
ration for  the  walls  or  mantlepiece,  and,  thanks  to 
her  deft  fingers  and  quick  perception,  you  are 
nearly  ready  to  begin  business.  Not  quite,  for  an 
examining  table  must  be  had,  and  the  sign. 

If  you  are  not  possessed  of  enough  money  to 
buy  one  of  the  numerous  patterns  of  tables  that 
are  on  the  market  you  can  make,  or  have  made, 


THE  PRACTICE  OF  MEDICINE  4! 

one  in  a  little  time  that  will  do  for  all  practical 
purposes.  Have  a  carpenter  make  a  common  board 
table  four  feet  long,  three  and  one  half  feet  high,  and 
three  feet  broad,  the  top  so  made  that  it  will 
elevate;  a  piece  of  board  placed  behind  and  held 
there  will  keep  the  top  stationary.  Two  leaves  can 
be  suspended  at  the  bottom  by  hinges.  Use  this 
until  you  are  able  to  buy  a  better  one.  Now  the 
sign.  This,  to  the  young  doctor,  is  of  the  greatest 
importance.  He  has  thought  of  it  many  times  in 
his  quiet  hours,  and  now  that  he  is  to  give  the 
order  for  its  making  he  hesitates,  for  he  must 
decide  a  number  of  questions  in  regard  to  it.  How 
large  must  it  be;  how  long,  how  wide  ?  Should  it 
be  of  dark  background  with  white  letters,  or  a 
white  background  with  black  letters  ?  No,  there 
is  a  commonness  about  both  these.  How  would  a 
green  background  and  gold  letters  look  ?  You 
decide  on  this  and  go  to  tell  the  "partner."  She 
hears  it  all,  then  modestly  suggests  that  a  black 
background  with  gilt  letters  would  look  best.  Of 
course  you  admit  it,  and  many  and  many  will  be 
the  times  in  your  future  life  that  you  will  ' '  admit " 
that  her  plan  is  the  best  and  her  way  the  proper 
way.  Many  a  man  would  have  been  saved  from 
financial  ruin,  degradation,  and  sorrow  had  he 
' '  listened  to  "  his  wife. 


42  HOW  TO  SUCCEED  IN 

The  inscription.  You  write,  "I.  Will  Catchem, 
M.  D."  This  does  not  seem  to  convey  enough 
meaning,  so  you  try  again :  ' '  Doctor  I.  Will 
Catchem,"  and  add  "Physician  and  Surgeon," 
but  she  suggests  "I.  W.  Catchem,  M.  D.,"  and 
so  it  is  agreed.  The  sign  completed,  it  must 
be  put  in  place.  Would  it  look  better  nailed  to  the 
' '  outward  walls, "  or  suspended  by  iron  bar  ?  You  are 
willing  now  that  she  should  decide.  But  you  had 
not  calculated  that  the  swinging  of  this  sign  to  the 
breeze  would  be  an  "  event "  in  the  village.  With 
hatchet,  nails,  and  sign  in  hand  the  start  is  made 
for  the  office.  The  little  procession,  composed  of 
yourself,  wife,  and  dog,  wend  along  a  back  street, 
but  before  many  paces  are  made  the  procession  is 
added  to  by  the  presence  of  numerous  urchins,  and 
when  the  work  of  ' '  putting  up  "  is  begun  the  grocer 
across  the  way  appears  at  his  front  door,  the 
butcher  ceases  to  "chop  meat, "and -the  shoemaker 
lays  down  his  ' '  last "  in  order  to  see  what  is  going 
on.  It  never  dawned  on  you  till  now  that  a  feeling 
of  real  modesty,  not  to  say  shame,  could  creep 
over  you  during  so  simple  an  act  as  ' '  putting  up  " 
your  sign.  But  you  are  convinced  of  it  now,  and 
with  great  trepidation  you  mount  the  stool  to  begin 
operations.  During  your  early  days  of  education 
the  teacher  had  neglected  to  say  to  you  that  it  was 


THE  PRACTICE  OF  MEDICINE  43 

important  that  you  become  acquainted  with  the  art 
of  driving  a  nail.  You  realize  before  this  sign  is 
hung  how  derelict  he  was  in  his  duty.  You  place 
this  precious  piece  of  tin  upon  the  iron  rod,  then 
with  a  slight  peg  it  is  held  to  its  place,  then  raising 
the  iron  rod,  which  has  been  bent  to  a  proper  angle, 
you  proceed  to  ' '  nail  it  to  the  wall. "  The  little 
wife  seeing  your  embarrassment — who  of  that  atten- 
tive crowd  does  not — stands  just  within  doors  and 
in  a  subdued  tone  says,  ' '  A  little  more  to  the  right, 
Jack,  a  little  more  to  the  right. "  As  the  days  come 
and  go,  when  age  creeps  on  you  apace,  when  eyes 
grow  dim,  the  cheeks  turn  pale,  the  limbs  totter  and 
hair  turns  white,  you  will  still  hear  the  echo  of  that 
voice,  forever  stilled  now,  "A  little  to  the  right, 
Jack,  a  little  to  the  right."  It  is  well  with  you  if, 
during  the  elapse  of  these  many  years,  you  have 
heeded  that  sweet  and  loving  advice.  You  raise 
the  hatchet  in  the  air,  and  with  what  you  thought 
a  well-directed  blow  it  descends,  not  upon  the  nail, 
but  upon  your  finger.  Stars  come  and  go,  light- 
nings flash  and  thunders  roll ;  you  forget  for  the 
moment  the  presence  of  the  anxious  crowd  or  the 
Sunday-school  sentiments  of  your  youth ;  your 
face  turns  red,  the  hatchet  drops,  perspiration 
stands  as  beads  on  your  forehead,  you  swallow 
saliva  by  the  mouthful ;  but  it  will  come  out,  you 


44  HOW  TO  SUCCEED  IN 

must  give  expression  to  your  sentiments,  and  you 
must  admit  it ;  the  sign,  this  sign  that  but  a  few 
moments  ago  you  would  have  taken  off  your  hat 
to  in  humble  respect,  is  damned.  One  minute 
afterward  you  would  have  given  "the  world"  if 
you  had  not  said  it,  for  what  would  she  say  ?  Glanc- 
ing sideways  into  the  door  you  see  her,  a  tear,  yes, 
a  tear  upon  her  cheek,  but  a  twinkle  in  her  eye  and 
a  twitching  of  the  muscles  of  her  face  that  indicates 
a  smile.  You  close  the  door,  take  her  in  your 
arms,  and  promise  never  to  say  it  again.  She 
suggests  that  it  might  be  a  good  idea  to  have  the 
carpenter  put  up  the  sign,  and  this  was  done — after 
nightfall. 

PERSONAL  APPEARANCE. 

Irving  says  of  Goldsmith,  when  he  re-entered 
the  medical  profession  for  the  purpose  of  securing 
an  income,  that  he  appeared  in  a  professional  wig, 
a  cane,  purple  silk  small-clothes,  and  scarlet  rogue- 
laure  buttoned  to  the  chin. 

A  distinguished  president  of  a  great  system  of 
railways  said  to  young  men,  ' '  If  you  have  twenty- 
five  dollars  and  want  a  job  it  is  better  to  spend 
twenty  dollars  for  clothes,  four  dollars  for  shoes, 
and  the  rest  for  a  shave,  a  hair  cut,  and  a  clean 


A  little  more  to  the  right,  Jack,  a  little  more  to  the  right." 

43 '• 


THE  PRACTICE  OF  MEDICINE  45 

collar  and  walk  to  the  place  than  go  with  the  money 
in  the  pockets  of  a  dingy  suit." 

Clothes  don't  make  the  man,  but  good  clothes 
have  gotten  many  a  man  a  good  job,  and  so  good 
clothes  and  a  neat  appearance  will  get  you  many  a 
good  patient. 

I  do  not  think  it  out  of  place,  now  that  you  are 
to  begin  practice,  if  a  few  suggestions  of  a  personal 
nature  should  be  considered.  Man,  at  best,  is  a 
helpless  creature  where  anything  looking  to  his 
personal  adornment  is  concerned.  Men  may  suc- 
ceed in  being  crowned  by  fame,  yet  it  would  puzzle 
them  to  tie  a  cravat  correctly.  They  may  attain 
to  great  estate  by  individual  effort,  but  they  could 
not  succeed  in  finding  a  collar-button,  although  it 
was  just  "under  their  nose."  Indeed,  the  average 
man  is  not  fit  to  occupy  apartments  alone,  for  in  a 
very  short  time  they  would  be  uninhabitable.  If  a 
man  decides  to  adorn  himself  in  the  latest  fashion 
he  is  apt  to  put  on  a  blue  shirt  with  a  full-dress 
suit,  or  a  plaid  pair  of  trousers  with  a  Tuxedo  coat. 
He  must,  at  all  times  and  in  all  places,  have  a 
hand  more  deft  than  his  to  guide  and  help  in  his 
personal  adornment.  The  minutia,  therefore,  I 
will  leave  to  her  sure  and  unerring  hand. 

Some  men  seem  to  think — some  doctors — that 
the  matter  of  apparel  does  not  require  considera- 


46  HOW  TO  SUCCEED 

tion  or  attention.  He  does  not  stop  to  think  that 
he  is  a  public  servant,  and  to  this  public  he  owes  a 
proper  amount  of  respect.  The  gallant  gentleman 
who  lifts  his  hat  to  all  ladies,  and  would  count  it  a 
discourtesy  to  sit  while  his  elder  stood,  surely  will 
not  feel  aggrieved  if  it  is  suggested  that  the  tobacco 
juice  should  be  wiped  off  his  chin,  or  that  he  should 
not  expectorate  in  a  street  car.  Yet  these  delicate 
distinctions  seem  to  some  to  be  invidious  and  com- 
monplace. It  is  not  necessary  to  buy  costly  cloth- 
ing in  order  to  be  neat,  and  shoe  polish  is  not 
expensive.  I  have  known  men  who  were  exacting 
when  manners  were  concerned  that  would  appear 
in  the  presence  of  ladies  with  unkempt  hair  or  a 
soiled  shirt.  Gaudiness  is  to  be  discountenanced  in 
either  man  or  woman,  but  neatness,  even  in  sim- 
plicity, is  to  be  commended.  Let  your  dress,  like 
your  speech,  be  above  reproach.  Cleanliness  is  a 
virtue,  and  filthiness,  either  in  character  or  clothes, 
is  to  be  abhorred.  Patients  are  acute  observers, 
and  the  least  thing  smacking  of  vulgarity  is  repul- 
sive to  them.  Exercise  discretion  in  dress  as  you 
would  in  the  buying  of  a  horse,  and  let  your  per- 
sonal appearance  always  bespeak  the  gentleman. 


CHAPTER  III 

MARRIAGE 

In  the  previous  chapters  I  have  talked  with  you 
as  "one  married  man  talks  to  another."  It  may 
be  that  some  doctors  who  will  read  my  ' '  sugges- 
tions" are  unmarried.  To  all  such  I  can  say 
' '  more's  the  pity. "  And  yet  it  must  be  admitted 
that  there  are  many  valid  reasons  for  a  man  not 
entering  into  this  blissful  or  unblissful  life.  I  know 
a  physician  of  great  distinction  of  whom  it  is  well 
known  that  his  reason  for  not  marrying  was  his 
devotion  to  his  aged  mother.  How  sweet  it  is  to 
contemplate  this  considerate  care  of  one  who,  in 
this  busy  world,  with  the  responsibility  of  many 
things  resting  upon  him,  let  nothing  prevent  or 
interfere  with  his  duty  and  affection  for  his  mother. 
I  have  seen  this  doctor  many  times  at  the 
annual  meetings  of  the  American  Medical  Asso- 
ciation accompanied  by  this  dear  old  sweet-faced 
mother.  As  I  would  watch  his  constant  care  of 
her,  his  strong  arm  supporting  her,  and  his  sooth- 
ing voice  comforting  her,  I  could  quite  understand 
that  this  peaceful  relation  should  not  be  disturbed. 
It  was  but  a  few  days  ago  that  during  a  visit  to  his 
city  I  said,  on  greeting  him,  "And  how  is  mother?" 


45  HOW  TO  SUCCEED  IN 

With  sad  countenance  he  replied,  "Why,  don't 
you  know  that  mother  is  dead  ?  "  I  walked  silently 
away,  and  reflected :  Oh,  you  dutiful  son,  you 
have  nothing  to  regret,  you  gave  to  her  the  affec- 
tion of  your  very  best  days,  you  comforted  and 
made  her  last  days  her  most  pleasant  ones ;  you 
cared  for  her,  as  she  had  cared  for  you,  and  now 
she  has  been  gently  laid  to  rest  by  your  own 
loving  hands.  Let  this  lesson  taught  by  one  of 
your  own  professional  brothers  be  an  object-lesson 
to  you  all  your  life  long.  As  you  lisped  the  name 
of  mother  with  prattling  lips,  let  her  name  and 
admonitions  go  with  you  down  to  the  grave. 
Another  physician  told  me  that  his  reason  for  not 
marrying  was  that  he  was  too  poor,  or  at  least 
that  he  did  not  feel  that  he  could  support  a  wife  in 
the  style  that  she  deserved.  This  was  a  kindly 
and  considerate  reason.  It  is  due  a  woman  that 
she  should  not  be  pulled  down,  as  it  were,  from 
affluence  to  what  she  would  consider  a  poor  condi- 
tion without  a  full  explanation  and  concurrence. 
And  on  the  other  hand  nothing  would  so  embarrass 
a  young  doctor  as  to  have  a  disappointed  woman 
on  his  hands.  While  we  are  considering  the  busi- 
ness side  of  this  very  important  question  we  can 
afford  to  be  more  explicit.  A  young  man  who  has 
any  sort  of  a  start  in  the  practice  of  medicine  can 


THE  PRACTICE  OF  MEDICINE  49 

not  be  regarded  as  a  very  poor  individual  from  a 
financial  standpoint,  though  it  may  be  that  he  has 
no  money.  Such  a  one  can  afford  to  say  to  the 
lady  in  question  or  contemplation,  "I  possess  the 
equivalent  of  your  ten  thousand  dollars  in  my 
diploma.  With  it  as  a  certificate  of  my  ability  to 
practice  medicine  I  propose  to,  at  least,  make  the 
very  first  year  the  sum  which  will  represent  the 
investment  of  your  money  at  legal  interest,  six  per 
cent,  namely,  six  hundred  dollars. "  This  would  be  a 
revelation,  and  should  teach  her  that  although  you 
may  not  be  a  bloated  bondholder  you  are  not  the 
"poor  trash"  she  took  you  to  be.  In  the  same 
ratio,  say  that  you  have  a  practice  that  yields  the 
sum  of  three  thousand  dollars  a  year,  this  gives 
you  the  net  value  of  fifty  thousand  dollars  invested 
at  six  per  cent  interest.  Why,  you  are  richer  than 
you  thought,  so  don't  allow  any  damsel,  however 
fair,  to  ride  rough-shod  over  you  when  it  comes  to  a 
matter  of  money.  Let  me  assure  you  that  when 
your  name  is  mentioned  in  the  house  the  father  is 
more  than  likely  to  remark,  "This  young  man 
promises  much;  I  have  watched  his  career  in  this 
community;  I  know  him  to  be  of  good  morals, 
excellent  character,  energetic,  and  a  first-rate 
doctor."  Think  you  that  such  an  endorsement 
from  the  ' '  head  of  the  house  "  will  not  have  effect 


$0  HOW  TO  SUCCEED  IN 

in  the  right  direction  ?  I  will  admit  that  often,  too 
often,  young  ladies  are  influenced  in  their  decision 
in  this  matter  by  glib  tongues,  fancy  neck-wear, 
money,  position,  and  the  ability  to  waltz  well  more 
than  by  morals,  brains,  energy,  ambition,  and  fidel- 
ity to  duty;  but  it  is  not  this  class  you  are  looking 
for,  so  I  would  dismiss  them,  but  before  doing 
so  let  me  warn  you  that  you  might  catch  one 
" unawares";  if  so,  God  have  mercy  on  your  soul. 
Viewing  marriage  from  a  monetary  standpoint,  a 
distinguished  physician  living  in  a  large  city 
recently  wrote,  and  I  submit  his  thoughts  to  you 
for  careful  consideration  without  comment : 

It  is  not  only  legitimate,  but  perfectly  ethical,  for  a 
moral  young  doctor  to  fall  in  love,  and  there  are  very  few 
wealthy  families  in  the  country  who  do  not  fancy  a  rising 
young  physician  for  a  prospective  son-in-law.  Thus 
business  can  be  combined  with  pleasure,  viewing  the 
matter  from  a  practical  standpoint.  It  may  be  said  that 
such  conduct  partakes  more  of  the  mercenary  than  the 
sentimental ;  but  why  should  not  young  doctors  have  the 
choice  of  all  that  gathers  where  wealth  and  beauty 
abound?  A  half-starved  young  disciple  of  ^Esculapius 
has  no  business  in  marrying  and  half  starving  some  pretty 
girl  without  means,  and  the  latter,  as  a  rule,  are  wise 
enough  not  to  allow  their  sentiment  to  run  away  with 
their  better  judgment ;  the  son  of  a  multi-millionaire  is 
their  acme  of  ambition,  and  most  wisely  so,  for  a  rich 
man's  son  may  be  married  without  any  failure  of  self- 
respect  or  public  esteem.  Indeed,  the  poor  girl  who 


THE  PRACTICE  OF  MEDICINE  5 1 

gains  one  should  be  congratulated,  and  her  error,  as 
regards  sentiment,  of  sins  of  omission  and  commission, 
condoned.  Many  a  lone  maid  of  fortune  has  gone  single 
for  a  lifetime  because  some  proud  but  poor  young  man 
failed  to  ask  her  hand  and  heart.  Every  promising  young 
doctor  is  certainly  entitled  to  success,  and  success  in  life 
more  often  comes  through  the  woman  than  the  man,  for 
the  American  girl  has  ever  been  the  maker  of  great  men. 
True  it  is  that  we  have  known  young  doctors  engaged  to 
be  married  year  after  year  to  some  beautiful  girl,  waiting 
for  the  time  when  their  profession  made  them  self-inde- 
pendent enough  to  take  her  for  wife,  waiting  until  the 
girl's  hair  grew  gray,  and  no  other  admirer  daring  to  look 
askance.  Long  engagements,  based  on  the  hope  of  com- 
ing business  prosperity  on  the  part  of  the  man,  are 
mistakes  ;  they  are  an  injustice  to  both  parties  concerned. 
True  it  is  many  such  engagements  turn  out  most  happily, 
but  love  at  an  elderly  age  is  scarcely  tinged  by  the  senti- 
mental, and  in  the  end  turns  out,  as  a  rule,  to  be  emi- 
nently of  the  practical  sort. 

People  of  refinement  and  education  with  no  means 
are  plentiful  in  this  country  ;  they  have  all  the  social 
aspirations  and  ambitions,  and  consequently  the  lack  of 
success  implies  sadness  rather  than  prospective  happiness. 
What  were  twenty  years  since  regarded  as  luxuries  are 
now  deemed,  even  by  the  hard-working  classes,  necessi- 
ties. The  ideal  love,  the  one  of  the  poets  and  artists, 
was  formerly  love  in  a  cottage  ;  now  the  cottage  must  be 
at  the  seaside  in  summer,  and  a  high-priced  and  richly 
furnished  flat  an  absolute  requirement  of  winter. 

Another  reason  given  me  by  a  young  doctor  for 
not  taking  upon  himself  the  marital  relation  was  a 
melancholy  one.  It  was  that  he  was  in  ill-health. 


52  HOW  TO  SUCCEED  IN 

How  just  and  merciful  was  this  young  man.  No 
doubt  but  that  he  had  at  one  time  or  another  felt 
his  bosom  rise  and  his  heart  beat  in  response  to 
that  feeling  that  makes  all  hearts  glad ;  in  moments 
of  sadness  the  tear  of  disappointment  has  bedimmed 
his  eye;  his  heart  has  yearned  for  the  fulfillment 
of  the  tie  that  makes  the  world  brighter  and  strews 
our  pathway  with  flowers  ;  he  has  felt  the  heat  of 
breath,  has  kissed  the  warm  lips,  has  clasped 
tenderly  the  gentle  form  of  the  one  that  he  loves. 
Yet  this,  all  this,  must  be  as  naught  to  him.  What 
a  sacrifice,  but  it  must  be  made!  Duty  rises  above 
all  things  earthly,  and  he  forfeits  the  claim  though 
it  breaks  his  heart.  Yes,  he  did  the  proper  thing, 
for  no  man  has  the  right  to  imperil  the  lives  of 
others  by  the  transmission  of  disease  to  them. 
Better,  far  better,  to  bear  the  disappointments  and 
sorrows  alone  than  to  give  to  posterity  a  physical 
blight  that  would  make  them  accursed  among  men. 
Let  your  admonitions  be  that  those  suffering  from 
certain  forms  of  disease  must  not  enter  the  married 
state.  ' '  The  sins  of  the  fathers  will  be  visited  upon 
the  children,  yea,  unto  the  fourth  generation."  I 
recognize  that  we  tread  not  only  upon  sacred,  but 
dangerous  ground  as  well,  when  we  attempt  to  deal 
with  the  marriage  relation.  Yet  I  feel  that  my 
duty  would  not  be  completed  unless  I  talked  to  you 


THE  PRACTICE  OF  MEDICINE  53 

freely  upon  this,  the  most  important  subject  that 
will  ever  engage  your  attention. 

To  those  of  my  readers  that  are  already 
married  I  would  bless  with  the  sweetest  bene- 
diction, and  pray  that  all  your  life  long  you 
may  find  the  most  perfect  joy  around  your  hearth- 
stone. To  the  young  doctor  that  has  not  yet 
been  so  blessed  I  would  ask  that  he  "lend  me 
his  ear. "  I  have  known  a  misguided  step  in  this 
direction  to  ruin  a  man's  life ;  to  pull  down  a  doctor 
from  an  exalted  position  in  his  profession  to  the 
very  depths  of  degradation;  to  make  good  men  bad; 
to  wreck  ambition  and  to  make  a  very  hell  of  a 
home  where  peace  and  quiet  once  reigned.  On  the 
other  hand,  I  have  known  men  addicted  to  all 
manner  of  sins  and  vices  made  upright  and  moral; 
men  of  poor  estate  to  become  enriched  in  this 
world's  goods;  men  of  mediocre  attainments  to  rise 
to  high  positions;  the  slothful  to  become  diligent; 
the  profane  to  cease  their  profanity;  drunkards  to 
be  reformed,  and  corrupt  men  to  become  men  of 
high  honor  and  esteem  by  the  efforts  of  a  good 
wife.  ' '  Look  you  then  upon  this  picture,  and 
upon  that. "  There  must  be  a  reason  for  all  this. 
Should  you  not  strive  to  discern  it?  It  lies  in  the 
selection  you  make  of  the  woman  who  is  to  be 
' '  bone  of  your  bone  and  flesh  of  your  flesh. "  Look 


54  HOW  TO  SUCCEED  IN 

well  to  this  selection.  But  you  will  say,  ' '  Am  I  not 
to  marry  the  woman  whom  I  love  ?  "  '  'Yes, "  I  would 
reply,  ' '  if  you  love  the  right  woman. "  If  you  were 
going  to  purchase  a  house  would  you  not  look  to 
see  if  the  walls  were  defective?  I  admired  a  most 
beautiful  horse  once,  but  found  that  he  was  too 
lame  to  be  of  any  service.  For  what  are  you  to 
love  a  woman  —  her  pretty  face  and  elegance  of 
figure?  A  wax  doll  is  very  much  the  same,  and  a 
butterfly  loses  its  beauty  in  a  day.  A  beautiful 
woman  —  the  Creator's  most  perfect  handiwork ! 
The  attempt  of  the  artist  to  catch  the  rich  coloring 
of  her  cheeks,  the  depth  of  her  great  blue  eyes, 
the  radiance  of  expression,  the  turn  of  lip,  the 
taper  of  fingers,  and  the  luster  of  her  hair  is  futile, 
and  his  brush  falls  to  the  ground  in  utter  ignominy. 
To  paraphrase  :  ' '  God  possibly  could  have  made  a 
more  beautiful  thing  than  a  beautiful  woman,  but 
he  never  did. "  Think  of  her  power.  A  man  will  go 
on  bended  knee  to  her;  the  clasp  of  her  hand  can 
drive  him  mad,  and  to  touch  her  lips  he  would 
sacrifice  wealth  and  honor.  Madness,  despair, 
drunkenness,  and  sorrow  go  in  her  wake,  for  men 
would  creep  in  mire  and  filth  to  do  her  command. 
The  history  of  the  world  recites  more  than  one 
Antony  and  Cleopatra,  and  thousands  have  gone  to 
their  death  by  drink,  by  opiate,  and  by  the  pistol- 


THE  PRACTICE  OF  MEDICINE  55 

shot  as  the  result  of  her  presence  and  influence. 
No,  not  alone  for  beauty  of  face,  but  rather  beauty 
of  character  should  you  select  the  one  who  is  to 
share  your  burdens  as  well  as  your  joys.  One 
possessed  of  natural  grace,  of  comely  appearance, 
of  health;  whose  disposition  is  as  charming  as  her 
traits;  whose  laughter  is  contagious.  One  whom 
men  speak  well  of  and  women  praise.  Educated, 
refined,  and  of  quick  perception,  not  given  to  gossip 
or  an  evil  tongue ;  one  who  believes  that  ' '  this  is  a 
beautiful  world  and  filled  with  very  pleasant  peo- 
ple " ;  one  who  knows  not  cant,  hypocrisy,  or  deceit, 
and  whose  manner  is  that  of  the  perfect  lady. 
Take  her,  for  she  will  be  an  honor  to  you,  and  her 
glory  will  be  everlasting. 


CHAPTER  IV 

ETHICS 

Do  unto  others  as  you  would  have  others  do 
unto  you,  and  if  you  are  ever  in  doubt  about 
the  proper  course  to  pursue,  consult  the  Code  of 
Ethics  of  the  American  Medical  Association. 


CHAPTER  V 

THE  FIRST  YEAR 

You  will  now  observe  that  people  frequently  call 
the  doctor  ' '  Doc. "  One  would  think  that  it  is  a 
simple  abbreviation,  but  I  am  satisfied,  after  giving 
the  subject  careful  consideration  for  over  thirty 
years,  that  it  is  not  so.  These  good  common  folk 
think  to  pay  you  a  compliment,  or  in  other  words 
come  nearer  your  heart  by  bestowing  upon  you 
that  which  they  believe  to  be  a  more  affectionate 
term  than  that  of  doctor ;  so,  therefore,  subdue 
your  dignity,  or  wrath  if  you  have  it,  and  take  this 
mark  of  esteem  in  the  manner  that  it  is  intended. 
This  is  a  very  different  thing  from  being  called  by 
your  given  name  by  a  man  that  has  not  known  you 
over  fifteen  minutes,  and  for  whom  you  have  no 
degree  of  respect ;  or  the  man  with  whom  you 
have  no  relations,  who  on  meeting  you  habitually 
' '  slaps  "  you  on  the  back,  when  it  would  be  more 
congenial  to  you  to  have  him  fifteen  miles  away. 
This  is  where  ' '  familiarity  breeds  contempt "  and 
calls  for  resentment,  but  ' '  what's  the  use  ?  " 

The  sign  up,  the  office  furnished,  and  the  larder 
well  or  partially  filled,  you  are  now  ready  to  begin 
practice.  There  are  some  resolutions  that  you 


$8  HOW  TO  SUCCEED  IN 

should  now  make  and  faithfully  carry  out  during 
your  whole  professional  life: 

First.  That  you  will  be  just,  and  wrong  no  man. 
I  believe  that  it  can  be  truthfully  said  of  the  medi- 
cal profession,  that  for  the  opportunities  offered  it 
is  the  most  honest  of  all  vocations.  The  patient 
is  at  your  mercy  in  many  ways  —  his  (or  her) 
life,  character,  and  money.  It  would  be  an  easy 
thing  to  deceive  him  and  wrong  him  in  any  one 
of  these  particulars.  If  you  are  not  competent  to 
battle  with  his  disease,  be  just  and  honest,  and  tell 
him  so.  This  very  honesty  will  redound  to  your 
credit  in  a  hundred  ways.  You  may  not  be  able 
to  make  a  proper  diagnosis:  lose  no  time  in  calling 
for  help.  You  may  not  be  able  to  perform  a  certain 
surgical  operation:  send  for  one  who  is.  You  may 
be  in  doubt:  give  your  patient  the  benefit  of  the 
doubt.  It  is  a  narrow  spirit,  indeed,  that  would 
not  do  each  of  these  were  it  necessary.  Remem- 
ber that  the  life  of  a  human  being  may  rest  upon 
your  honesty  of  purpose  and  quick  decision.  It  is 
painful  to  know  that  there  are  doctors  who  for 
fear  that  their  talents  may  be  underestimated  will 
deliberately  undertake  to  do  things  in  medicine 
or  surgery  which  they  know  to  be  impossible 
for  them  to  do.  This  is  little  less  than  criminal. 
Many  lives  have  been  sacrificed  by  such  bigotry. 


THE  PRACTICE  OF  MEDICINE  59 

If  you  have  in  the  proper  way  prepared  yourself 
to  cope  with  the  case  in  hand,  and  have  the  consent 
of  an  honest  conscience,  go  ahead,  and  you  will 
feel  no  remorse,  be  the  result  what  it  may.  The 
character  of  your  patient  is  at  your  mercy.  He  is 
often  forced  to  confide  in  you  secrets  of  such  a 
nature  that,  were  they  known,  would  ruin  him 
socially,  and  possibly  financially  and  morally.  I 
will  not  stop  here  to  argue  with  those  who  say  that 
if  one  has  sinned,  he  deserves  to  be  exposed.  It 
certainly  is  not  your  duty  to  expose  them,  and  if 
perchance  their  secrets  should  become  known,  you 
are  not  to  confirm  such  reports.  The  secrets  of 
the  sick  chamber  are  sacred,  and  no  court  or  person 
should  have  the  right  to  compel  you  to  divulge 
them.  Let  your  tongue  cleave  to  the  roof  of  your 
mouth  and  your  arm  be  palsied  at  your  side  before 
you  betray  them.  It  must  be  understood  that  there 
are  things  and  conditions  which  exist  between 
physician  and  patient  sometimes  that  are  just  as 
secret  in  nature  as  those  hinted  at,  and  are  without 
sin  or  censure.  The  family  doctor  is  intrusted 
with  things  of  the  greatest  moment,  financial  and 
otherwise.  And,  too,  disease  may  come  to  the 
most  innocent,  of  a  nature  that  is  most  damaging, 
yet  the  world  might  be  unable  to  draw  a  distinction 
of  classes,  and  the  pure  and  virtuous  would  be 


6O  HOW  TO  SUCCEED  IN 

wrongfully  damaged  by  idle  tongues.     Look  to  it 
that  you  protect  all  such. 

Second.  That  you  will  always  be  ready  to  serve 
the  poor,  even  without  price.  The  rich  can  take 
care  of  themselves,  but  the  poor  are  dependent 
upon  others.  You  can  be  the  means  of  giving  to 
them  the  greatest  of  all  charities  —  medical  atten- 
tion when  sick  and  afflicted.  The  world  is  dark 
enough  to  them,  God  knows,  so  never  fail  to 
lighten  their  burdens  whenever  you  can.  At  last, 
they  are  the  best  and  truest  of  friends.  A  kind 
word,  a  smile,  a  little  interest  in  their  welfare  goes 
a  long  way  with  them,  and  their  blessing  is  worth 
more  to  you  than  an  idle  compliment  from  a  higher 
source.  It  is  a  pleasant  memory  to  the  writer 
that  upon  one  occasion  a  member  of  his  own  family, 
who  was  a  doctor,  upon  being  called  to  see  a  rich 
patient  replied :  ' '  You  are  able  to  employ  another 
physician;  I  will  go  with  this  poor  man,  who  is  not 
able  to  pay."  He  has  long  since  gone  to  his 
reward,  and  I  do  not  question  but  that  this  act  will 
be  set  down  to  his  credit  by  the  Creator  of  men. 
Let  it  never  be  said  of  you  that  you  refused  at  any 
time  to  attend  the  poor  when  able  to  do  so. 

Third.  That  you  will  put  an  honest  estimate 
upon  your  services,  and  demand  that  they  be  paid 
for  by  every  one  able  to  do  so.  It  is  no  credit  to  a 


THE  PRACTICE  OF  MEDICINE  6l 

doctor  to  say  of  him  that  he  is  a  poor  business 
man,  a  bad  collector,  etc.  Yet  it  has  become 
proverbial  that,  as  a  class,  the  medical  profession  is 
composed  of  men  who  know  absolutely  nothing 
about  business  methods.  You  will  underrate  your 
profession  and  do  an  injustice  to  your  family  if  you 
pursue  such  a  course  ;  in  doing  so  you  get  no  credit 
and  deserve  none.  As  I  will  have  more  to  say  on 
this  subject  I  will  make  this  hint  suffice  here. 

In  this  connection  I  will  relate  two  odd  ways  of 
collecting  old  debts.  An  old  doctor  once  told  me 
how  he  collected  a  debt  of  long  standing.  A  man 
living  up  in  the  hills  had  persisted  for  ten  long 
years  in  saying  that  he  was  unable  to  pay  anything 
on  account.  On  one  occasion  the  doctor  was  told 
that  this  party  had  taken  his  year's  crop  of  tobacco 
to  town  to  sell.  The  doctor  waited  patiently  for  his 
return,  and  one  day  was  rewarded  by  seeing  him 
get  off  the  train.  Walking  up  to  him  he  addressed 
him  thus  :  "Jim,  I  came  very  near  having  a  fight 
about  you  last  night."  "Why,  how  was  that, 
Doc.  ?  "  ' '  Well,  you  see,  a  number  of  us  were  con- 
gregated at  the  corner  store  as  usual  after  supper 
when  your  name  was  introduced.  One  man  said 
that  he  regarded  you  as  a  consummate  dead  beat 
who  would  never  pay  your  debts,  and  strange  to 
say,  Jim,  every  one  present  agreed  with  him.  I  spoke 


62  HOW  TO  SUCCEED  IN 

up  and  said:  'Gentlemen,  you  must  not  say  that 
about  Jim,  for  he  is  all  right ;  all  he  needs  is  time  to 
pay  his  debts. '  One  spoke  up  and  said  :  '  Well,  I 
always  knew  he  wanted  somebody  to  pay  them,  and 
if  time  will  pay  them,  you  bet  he  will  let  time  do  it.' 
This  made  me  mad  and  we  got  into  a  quarrel 
which  came  near  winding  up  in  a  fight,  and  all 
about  you."  "Doc.,"  says  Jim,  "I  always  knew 
that  you  were  a  friend  of  mine  ;  and,  by  the  way, 
Doc.,  how  much  do  I  owe  you  on  that  old  account?" 
"Well,  Jim,  you  owe  all  of  it,  as  you  have  never 
paid  me  a  cent,  and  it  has  been  running  for  over 
ten  years."  "Here,  Doc.,"  says  Jim,  "is  a  ten- 
dollar  bill,  and  I  will  hand  you  another  when  I  sell 
my  tobacco  next  year. "  The  old  doctor,  in  relating 
the  story,  said  it  was  just  like  finding  it  in  the  road 
or  in  a  horse-shoe  track.  If  all  plans  fail,  you 
might  try  this  one,  and  if  it  works  give  the  amount 
to  your  wife  for  ' '  pin  money. " 

A  young  physician  of  athletic  proportions  was 
standing  at  a  wharf  on  the  Kentucky  River  when  a 
gentleman  approached  him  and  asked  if  he  could 
not  pay  a  small  amount  that  he  owed  him.  It  was 
well  known  of  this  young  doctor  that  he  was  a 
"poor  collector"  and  seldom  had  money.  In 
reply  to  the  request  of  the  gentleman,  he  said  : 
• '  Just  wait  a  minute,  and  I  will  get  the  amount  and 


THE  PRACTICE  OF  MEDICINE  63 

pay  you. "  Walking  over  to  a  tall  fellow,  he  said  : 
' '  Bill,  I  owe  a  gentleman  five  dollars,  and  he  has 
asked  me  for  it ;  please  let  me  have  it. "  ' '  Why, 
Doc. ,"  said  the  man, ' '  I  haven't  a  cent. "  ' '  Oh,  yes 
you  have,  Bill,  for  I  just  this  minute  saw  a  gentle- 
man pay  you  for  your  tobacco."  Changing  his 
tune,  he  replied :  ' '  But,  Doc. ,  I  can  not  spare  a  cent 
of  that."  "Bill,"  asked  the  doctor,  "for  what 
length  of  time  have  I  attended  your  family  ? " 
"For  about  four  years,  I  think,  Doc."  "Did  I 
ever  ask  you  for  money  before  this,  or  did  you  ever 
pay  me  any  ?  "  "  No,  Doc. , "  said  Bill.  ' '  Well, 
now,  I  will  give  you  two  alternatives  and  you  can 
accept  either  one.  You  must  give  me  five  dollars 
in  the  next  two  minutes  or  go  into  that  river  head 
foremost."  Bill,  thinking  that  the  doctor  was  jest- 
ing, again  refused,  when  he  was  taken  by  the  nape 
of  the  neck  and  the  seat  of  his  trousers  and  thrown 
bodily  into  the  river.  A  bystander  told  me  that 
' '  Bill "  had  a  difficult  time  of  it  to  get  out,  but  that 
he  received  no  help  from  the  crowd  on  the  wharf, 
all  of  them  being  on  the  "doctor's  side."  For 
simple  diversion  you  might  try  this  plan  some  time, 
and  if  you  do  not  get  the  money,  like  the  doctor 
you  will  be  repaid  in  ' '  satisfaction. " 

Fourth.    That  you  will  never  misrepresent  the  at- 
tainments of  any  doctor  or  deride  him  in  any  way. 


64  HOW  TO  SUCCEED  IN 

I  am  sorry  to  chronicle  the  fact  that  I  have  known 
members  of  the  profession  to  willingly,  if  not  with 
malice  aforethought,  misrepresent  their  medical 
brethren.  Such  a  thing  should  be  unknown  in  any 
collection  of  gentlemen.  Oftentimes  you  are  not 
acquainted  with  the  facts  except  upon  mere  ' '  hear- 
say, "  and  such  evidence  is  the  vilest  of  all  and 
would  not  be  admitted  by  any  court  or  other  tri- 
bunal of  justice.  Even  admitting  that  you  are 
possessed  of  facts  sufficient  to  establish  the  truth- 
fulness of  your  assertion,  it  is  unjust  and  ungentle- 
manly  to  use  them  save  in  the  rarest  of  cases. 
Neither  should  you  deride  your  professional  brother. 
Life  is  too  short  and  duty  too  exacting  to  have 
bitter  controversies,  to  deal  in  vituperation,  or  seek 
to  do  injury  to  one  who  has  not  harmed  you.  Men 
are  often  better  than  they  seem,  nor  can  they 
always  be  told  by  their  exterior.  I  have  in  mind  a 
man  of  cold  but  dignified  bearing,  of  few  words,  and 
a  manner  that  would  seem  to  indicate  an  icy  feel- 
ing for  his  fellow-man,  yet  I  have  seen  this  man 
moved  to  tears  by  sympathy  for  others.  Don't 
judge  men  by  what  other  people  say  of  them,  but 
by  what  you  really  know,  and  then  be  sure  that  you 
know  it.  You  must  remember  that  you  are  judg- 
ing the  whole  world  by  one  standard.  This  will 
never  do,  for  men  are  wielded  and  controlled  by 


THE  PRACTICE  OF  MEDICINE  65 

circumstance,  and  environment  has  much  to  do 
with  making  character.  Many  things  —  good  or  bad 
looks,  disposition,  manner,  intelligence,  and  a  host 
of  others  —  come  by  inheritance.  Rather  blame  cir- 
cumstance, environment,  or  the  Creator,  than  the 
individual.  A  large  man,  of  phlegmatic  disposition, 
was  chiding  a  small,  irritable  man  for  being  angry: 
' '  Go  away, "  said  the  little  man,  ' '  you  are  not  the 
one  to  rebuke  me;  I  have  been  madder  in  the  last 
fifteen  minutes  than  you  have  been  during  your 
whole  life."  So  it  is;  we  are  not  all  built  the  same 
way,  so  overlook  the  supposed  fault  of  others  and 
keep  a  keen  eye  on  yourself.  Do  not  deride  any 
man,  for  you  yourself  may  reap  derision. 

Fifth.  That  you  will  not  be  misled  by  idle 
gossip,  and  will  never  indulge  in  the  same  yourself. 
Puck  exclaims  ' '  How  the  world  is  given  to  lying! " 
he  could  have  added,  ' '  and  to  gossip. "  You  will  not 
be  long  in  the  medical  profession  before  you  realize 
that  the  world  is  full  of  it.  No  profession,  trade, 
or  avocation  but  what  is  infected  by  it.  It  is  a 
powerful  weapon,  and  by  its  thrusts  homes  have 
been  wrecked,  men  sent  to  the  madhouse,  the  fair 
name  of  woman  despoiled,  and  fortunes  swept  away 
as  by  the  wind.  Its  tongue  is  as  vile  as  hell,  its 
bite  as  venomous  as  the  scorpion,  and  it  feeds  upon 
virtue  and  the  good  name  of  its  victims.  It  is  the 


66  HOW  TO  SUCCEED  IN 

devil  incarnate,  insatiable,  corrupt,  and  degrades 
by  its  polluting  breath.  Have  none  of  it,  but  put 
it  by  as  you  would  the  rattlesnake  that  had  crept 
into  your  bosom.  Men  and  women  will  come  to 
you  under  cover  of  professed  friendship  and  recite 
their  damnable  tales  of  gossip,  knowing  full  well 
that  there  is  no  truth  in  them,  and  gloat  over  the 
sorrows  of  their  victims  as  a  panther  gloats  over 
its  fallen  prey;  a  sweet  morsel  rolled  under  the 
tongue,  composed  of  malice,  envy,  jealousy,  false- 
hood, and  bitter  hatred.  Stamp  your  foot  upon  it 
as  you  would  upon  the  slimy  serpent  under  your 
foot.  When  men  come  to  you  to  tell  some  nauseous 
tale,  what  this  one  or  that  one  has  said  about  you, 
turn  a  deaf  ear.  When  women  delight  to  narrate 
their  morbid  effusions  —  this  patient  said  that, 
the  family  did  this,  ' '  confidentially" —  tell  them  to 
' '  Go  to !  go  to !  "  Let  not  your  tongue  be  guilty  of 
repeating  any  such,  but  rather  be  prepared  always 
to  defend  character  and  protect  virtue.  Avoid 
sarcasm,  also,  for  it  is  a  twin  brother  of  gossip. 
Its  shafts  have  pierced  many  hearts  and  caused 
many  bitter  tears ;  it  is  a  "  thorn  in  the  flesh, "  and 
before  you  are  aware  of  it  it  will  drive  from  you 
friends  of  a  lifetime.  It  is  a  whip  that  stings  and 
is  always  a  thing  of  torture,  although  the  victim 
may  receive  it  with  smiles.  Why  do  such  an 


THE  PRACTICE  OF  MEDICINE  6/ 

extraordinary  number  of  people  indulge  themselves 
so  wantonly  in  verbal  cruelty?  It  is  common  for 
those  who,  so  far  as  action  is  concerned,  leave  little 
to  be  desired,  to  go  about  armed  with  this  whip 
with  which  to  torment  their  neighbors.  They  get 
so  much  pleasure  out  of  watching  the  accurate  way 
in  which  their  cuts  go  home  and  the  winces  of  their 
victims  that  finally  the  sport  becomes  absorbing, 
and  they  do  not  spare  even  those  they  love,  until 
one  day  they  find,  to  their  horror,  that  they  have 
destroyed  that  delicate  plant  known  as  natural 
affection. 

Sixth.  Remember  to  keep  your  wife's  secrets 
from  your  patients,  and  your  patients'  secrets 
from  your  wife.  This  injunction  is  not  meant,  and 
can  not  be  construed,  to  be  any  reflection  upon  the 
good  wife.  She  is  not  interested  in  things  of  a 
private  nature  which  concerns  your  patients,  and 
surely  your  patients  have  no  right  to  be  informed 
of  the  private  affairs  of  your  home.  Again, ' '  there 
are  wives  and  wives."  We  are  easily  convinced 
that  our  neighbor's  wife  may  ' '  tell  tales  out  of 
school,"  but  ours,  no!  never.  Well,  our  neighbors 
may  have  the  same  process  of  reasoning.  Let 
each,  your  home  and  your  patients'  bedside,  be  a 
holy,  sacred  place,  and  nothing  must  enter  therein 
to  cause  discord  or  make  afraid. 


68  HOW  TO  SUCCEED  IN 

It  is  night — the  first  night  in  your  home.  The 
sign  is  hung  and  the  office  is  ready  for  the  recep- 
tion of  patients.  The  first  meal  has  been  eaten, 
the  dishes  cleared  away,  and  you  and  your 
"partner"  are  sitting  around  the  hearth.  The 
logs  of  wood  crack  and  splutter  as  they  send  out 
the  bright  flame  that  makes  you  so  warm  and 
comfortable  that  you  forget  the  blasts  of  winter 
outside  the  door.  You  watch  the  flame  as  it  grows 
larger  and  larger,  and  climbs  higher  and  higher, 
and  in  your  reverie  you  imagine  that  this  is  sym- 
bolic of  your  ambition.  "Well,  I,  like  this  flame, 
will  ascend  higher  and  higher  in  the  estimation  of 
the  people.  Will  my  life  be  as  bright  as  is  shown 
in  its  effulgence ;  will  I  be  able  to  overcome  all 
obstacles  as  it  does  on  its  march  upward  ;  will  I 
spread  warmth  and  comfort  to  the  sick  and  dis- 
tressed as  it  does  to  me  ?  "  So  long  has  been  your 
reverie  that  the  blaze  is  gone  and  nothing  but 
embers  are  left.  So  you  say,  ' '  Will  this  be  my 
life?  —  in  youth  the  glare,  the  light,  the  warmth; 
then  comes  age  creeping  on,  and  all  that  is  left  is 
embers  —  dead  embers."  "Jack" — this  is  your 
nickname,  born  of  love,  in  the  heart  of  her  that 
speaks  — ' '  don't  you  think  that  you  have  mused 
long  enough  ?  "  You  are  aroused,  and  the  clock 
on  the  wall  tolls  out  the  hour  of  twelve.  The  clock 


THE  PRACTICE  OF  MEDICINE  69 

on  the  wall — the  dear  old  clock !  What  an  im- 
portant factor  you  are,  to  be  sure,  in  the  transactions 
of  this  busy  world.  You  tell  us  the  hour  to  get 
out  of  bed  and  the  time  to  retire.  What  an  exact- 
ing master  you  are,  indeed.  Children  abuse  and 
fuss  at  you  for  interrupting  their  games  and  putting 
them  to  bed,  or  sending  them  to  school ;  the  frivo- 
lous young  maiden  scolds  or  praises  you  in  turn  as 
you  bring  her  sweetheart  to  her  or  keep  him  away 
one  minute  in  time  ;  the  young  man  blesses  or 
curses  you  for  being  slow  or  fast,  as  suits  his  plans ; 
you  regulate  and  control  the  affairs  of  men,  and 
wait  not  for  women  to  beautify  their  faces;  by 
your  dictation  dinner  is  served,  the  cows  come 
home,  and  the  sun  goes  down  behind  the  horizon ; 
you  direct  the  moving  of  trains,  the  sailing  of  ships, 
and  the  attack  of  armies  in  battle;  you  bring  us 
into  this  world  on  time,  and  sound  the  last  note  at 
the  departure  of  the  soul.  ' '  The  child  was  born 
at  twelve  minutes  before  nine,  but  the  fond  mother 
died  at  precisely  ten  minutes  past  twelve  by  the 
clock. " 

You  retire,  but  are  able  to  sleep  only  by  ' '  fits 
and  starts  "  at  first ;  at  last  consciousness  is  gone, 
and  you  are  wrapped  in  heavy  slumber.  You  are 
awakened  by  the  barking  of  the  dog.  You  lose 
consciousness  again  for  just  a  minute,  but  it  seems 


7O  HOW  TO  SUCCEED  IN 

an  hour,  so  rapidly  did  you  move  through  dream- 
land. It  is  said  that  occurrences  which  it  would 
take  hours  to  fulfill  rush  through  the  mind  in  one 
minute's  time  in  a  dream.  You  dreamt  that  mis- 
fortune had  overtaken  you  ;  that  ' '  in  rags  and 
tatters"  you  had  left  your  home;  that  all  your 
friends  had  deserted  you,  and  that  homeless  and 
friendless  you  were  wandering  through  the  world 
alone — no,  not  alone,  for  by  your  side  was  one 
faithful  companion,  the  dog.  You  say  to  him, 
"Good  and  true,  faithful  and  confiding  friend, 
starvation  can  not  daunt  your  affection  nor  fatigue 
cause  you  to  desert.  Would  that  the  world  would 
profit  by  your  example,  for  then  deceit  and  hypoc- 
risy would  be  unknown. "  A  loud,  clear  voice  calls 
"Hello,"  at  the  gate,  and  this  time  you  are 
awakened  indeed.  Is  it  not  strange  that  the  bark 
of  a  dog  could  suggest  such  a  dream  ? — but  it  is  true. 
You  awake  with  a  start,  and  wonder  what  on  earth 
it  can  mean  at  this  late  hour  of  night.  Some  one 
must  be  in  distress  ;  perhaps  a  fire  in  the  neighbor- 
hood, or  burglars  in  the  house.  Turning  to  the 
little  woman  by  your  side  you  ask  its  meaning, 
when  she,  in  turn,  suggests  that  possibly  it  may  be 
a  ' '  call  "  for  the  doctor.  Man-like,  you  say  to  her 
that  she  had  better  hoist  the  window  and  inquire 
what  the  matter  is.  Foolish  woman,  she  proceeds 


THE  PRACTICE  OF  MEDICINE  71 

at  once  to  execute  this  suggestion.  Could  she  but 
read  the  future  she  would  hesitate  before  doing  so, 
but,  woman-like,  she  does  not  stop  to  consider 
when  danger  threatens.  Many,  many  nights,  as 
the  years  come  and  go  apace,  she  will  be  called  to 
do  this  self-same  thing.  Yea,  more  than  this,  she 
will  be  forced  to  perjure  herself,  as,  for  instance, 
this  conversation  will  take  place  while  she  stands 
at  the  window  with  the  cold  wintry  blast  blowing 
in  upon  her:  Husband:  "Ask  him  who  is  sick." 
Wife  :  ' '  Who  is  sick  ?  "  Messenger  :  ' '  Tom 
Jones."  Husband  :  "  Say  that  I  am  not  at  home." 
Wife  (with  weak  voice) :  ' '  The  doctor  is  not  at 
home."  Shame  on  you  !  How  will  you  ever  get 
forgiveness  for  compelling  that  dear  Christian 
truthful  wife  of  yours  to  tell  this  same  false- 
hood over  and  over  again?  On  this  particular 
first  night  the  following  conversation  took  place: 
Wife  (at  window) :  ''What  is  the  matter?"  Man 
(at  the  gate) :  ' '  Mrs.  Goeasy's  child,  down  on  the 
creek,  is  dying  and  wants  the  doctor  to  come  as 
quick  as  possible. "  Wife :  ' '  The  doctor  lives  down 
the  —  Oh  !  you  mean  Jack — say,  Jack,  the  man 
wants  you — it's  a  call,  it's  a  call,  Jack!"  You  get  up, 
dress  in  a  hurry,  go  to  the  stable,  saddle  your 
horse  in  a  jiffy,  and  ride  hurriedly  away  with  the 
man.  No  more  sleep  for  the  little  woman  that 


72  HOW  TO  SUCCEED  IN 

night,  but  she  gets  up,  busies  herself  about  the 
house,  and  muses:  "Well,  well;  isn't  this  fortu- 
nate, a  call  the  very  first  night.  I  wonder  if  the 
child  is  very  sick;  but  that  doesn't  matter,  'Jack' 
will  cure  it."  So  like  the  true  and  faithful  wife!  I 
wonder,  sometimes,  if  we  appreciate  them  one  half 
as  much  as  they  deserve.  Come  what  will,  poverty, 
sickness,  or  crime,  she  stands  ready  to  defend. 
Men  may  slander  and  women  abuse,  but  she  is  un- 
moved in  her  fidelity.  Friends  may  prove  false 
and  those  of  your  own  blood  revile  you,  but  she 
never  deserts  her  post,  which  has  for  its  founda- 
tion love,  affection,  and  trust.  She  still  muses: 
* '  Wonder  if  Jack  will  know  the  way  back  ;  suppose 
that  he  should  get  wet ! "  Never  mind,  little  woman, 
let  him  get  used  to  it.  In  the  coming  years  there 
will  be  many  dark  nights,  the  thunders  will  roll,  the 
lightning  flash,  and  the  rain  come  down  on  ' '  poor  " 
Jack's  head.  He  has  joined  the  ranks  of  this  self- 
sacrificing  army  and  he  must  march  to  the  music, 
however  doleful  it  may  sound.  The  air  will  be 
ladened  with  the  sighs  of  the  afflicted,  the  moans 
of  the  distressed,  and  the  cry  of  the  widow  and 
orphan.  The  moon  and  the  stars  will  be  his  com- 
panions by  night  and  the  soft  winds  will  sing  a 
lullaby  to  him  as  he  goes  on  his  lonely  way.  But 
still  she  muses:  "I  wonder  how  much  Jack  will 


THE  PRACTICE  OF  MEDICINE  73 

get  for  this  visit."  Trust  a  woman  to  see,  even 
through  tears,  the  financial  profit  in  a  trade.  Bless 
her,  if  she  did  not  we  doctors  would  go  into  early 
bankruptcy.  If  she  is  to  be  a  partner  indeed,  put 
her  in  trust  of  the  purse-strings.  Don't  bother,  little 
woman,  about  how  much  Jack  will  get  for  this  visit ; 
look  on  his  books  ten  years  from  now,  debit  side, 
and  see  if  it  does  not  still  stand  unpaid.  Any- 
way, Jack,  remember  that  "there's  a  light  in 
the  window  for  you  "  to-night,  and  when  you  reach 
home,  dry  clothing  to  put  on  and  hot  bottles 
for  your  feet  will  be  ready  for  you.  True, 
that  in  alter  years  you  will  not  need  them, 
but  use  them  to-night,  Jack,  just  to  please  the  little 
wife.  During  all  this  time  you  are  wending  your 
way  through  woods  and  dales  to  Mrs.  Goeasy's  on 
the  creek;  the  gentleman  is  giving  you  much  in- 
formation, but  that  which  pleases  you  most  is 
"that  he  has  decided  to  employ  you  in  the  future 
as  his  family  doctor, "  that  he  has  a  family  consisting 
of  a  wife  and  thirteen  children.  You  are  elated 
over  this  for  several  weeks,  until  one  day  while 
you  are  standing  on  the  street  having  a  friendly 
talk  with  the  other  doctor  who  is  located  in  the  town 
this  individual  passes,  when  the  doctor  remarks, 
"There  goes  the  biggest  dead-beat  in  the  country; 
he  could  pay  if  he  would  try,  but  he  never  tries. " 


74  HOW  TO  SUCCEED  IN 

You  say  nothing,  but  walk  away  to  —  think,  and 
so  you  have  kept  on  thinking  for  these  many  years, 
why  it  is  that  some  people  are  so  ungrateful,  why 
others  do  not  pay  their  honest  debts  when  they 
could  if  they  only  tried  ;  why  the  world  is  so  given 
to  lying,  when  it  is  just  as  easy  to  tell  the  truth. 
But  with  all  this  thinking  you  will  never  be  able  to 
solve  the  question.  This  digression  carried  us 
away  from  your  visit  to  the  sick  (?)  child.  Arriving 
at  the  end  of  the  journey,  you  find  that  the  house 
is  dark  and  not  a  voice  is  heard.  You  wonder  if 
the  little  sufferer  has  passed  away,  and  if  the  poor, 
distressed  mother  is  weeping  all  alone  in  the  dark. 
The  messenger  walks  into  the  hall  (there  are  no 
locks  on  the  doors,  nor  need  to  be,  for  these  country 
people  are  honest)  and  you  stalk  in  after  him ;  you 
hear  a  sound  that  resembles  distant  thunder;  you 
are  impressed  with  its  regularity,  rise  and  fall  —  dis- 
tinct, then  indistinct  —  but  with  vibrations  equal  in 
movement  to  the  swinging  of  the  pendulum  of  a 
clock. 

A  knock  on  the  chamber  door  by  the  "mes- 
senger" and  you  hear,  first,  a  distinct  "snort," 
very  much  like  that  given  out  by  a  valiant  steed  as 
he  ceases  his  prances  in  a  ten-acre  lot;  then  a 
voice  —  a  female  voice,  too — says  "come in."  You 
then  realize  that  the  "tones  of  thunder"  came 


THE  PRACTICE  OF  MEDICINE  75 

from  her  throat  while  in  deep  slumber.  (It  is  no 
reflection  upon  the  feminine  character  to  say  that 
it  sometimes  snores ;  yet  it  is  a  strange  fact  that 
when  accused  of  it  it  always  denies  the  accusation. 
Why,  deponeth  sayeth  not. )  "Is  this  the  doc- 
tor? Well,  'Doc.,'  I  am  very  much  'obleeged' 
to  you  for  coming,  but  my  baby,  '  Sal, '  is  all 
right ;  she  was  a-sleepin'  so  sound  that  I  thought 
perhaps  she  might  be  a-dying,  so  you  see  I  asked 
Mr.  Goquick  here  to  go  after  the  doctor.  Sal, 
she  waked  up  jest  after  he  started,  but  he  was  too 
fur  on  the  road  to  call  him  back.  Have  a  cheer?" 
Instead  of  being  angered  at  this  recitation,  you 
are  rather  gratified,  for  you  had  been  puzzling 
your  brain  during  the  entire  ride  as  to  what  you 
would  do  should  this  or  that  be  the  case. 

Now  you  are  released  from  all  responsibility, 
and  after  thanking  the  lady  for  her  patronage  you 
wend  your  way  home;  on  one  thing,  however,  you 
are  determined,  that  is,  that  you  will  not  tell  the 
wife  the  child  was  not  sick.  But  you  did  not 
anticipate  such  a  difficult  time  as  you  encountered 
and  the  number  of  subterfuges  that  you  had  to 
resort  to  in  order  to  keep  her  from  knowing  the 
truth.  To  this  day  you  look  back  in  amazement 
and  congratulate  yourself  on  your  success  in  the 
matter.  Just  to  think  of  the  questions,  and  how 


76  HOW  TO  SUCCEED  IN 

you  squirmed  in  your  effort  not  to  tell  a  real  lie. 
"What  was  the  matter  with  the  child?  Was  it 
very  sick?  Did  it  suffer  much  pain?  How  old 
was  it?  Was  it  a  boy  or  girl?  What  was  the 
color  of  its  hair?  Do  you  think  it  will  get  well? 
Was  the  mother  (poor  mother!)  much  scared? 
How  long  did  it  take  you  to  relieve  it?  When  are 
you  going  back  to  see  it?  Was  it  a  pretty  child? 
Did  it  look  like  the  father  or  mother?  What 
was  its  name?  How  much  will  you  get  for  the 
visit?"  Poor  little  wife,  you  have  long  since 
learned  that  it  is  of  no  use  to  ask  these  questions, 
and  now  you  rest  content  to  know  that  ' '  Jack " 
is  having  as  much  practice  as  he  can  do.  Time 
goes  on,  and  you  find  yourself  gradually  "work- 
ing into"  practice.  You  have  found  that  it  is 
necessary  for  the  practitioner  in  the  country  to 
be  a  "  general  specialist, "  therefore  you  have  pro- 
vided yourself,  among  other  things,  with  a  pair  of 
tooth  forceps;  true  that  you  have  never  yet  ex- 
tracted a  tooth,  but  there  must  be  a  beginning. 
Well  it  is  that  you  have  them  "in  stock,"  as  the 
next  few  days  will  show.  On  a  dark  night,  after  the 
doctor  has  gone  to  bed,  he  is  aroused  by  that  now 
familiar  ' '  hello "  at  the  gate.  Wife  hoists  the 
window,  and  informs  him  that  it  is  Mr.  Planter,  a 
wealthy  farmer,  who  lives  near  the  town,  and  that 


THE  PRACTICE  OF  MEDICINE  77 

he  wants  a  tooth  " pulled."  The  doctor  hastens 
down,  and  accompanied  by  the  patient  they  go  to 
the  office  ;  the  coal-oil  lamp  is  lighted,  which  by 
this  time  has  become  ' '  dingy "  from  dust  and 
smoke  ;  but  little  oil  is  in  it,  but  by  shaking  it  up 
you  trust  to  its  ' '  holding  out  "  until  you  can  extract 
the  tooth,  as  you  say,  mentally,  it  will  take  but  a 
minute.  Foolish  man,  you  but  emphasize  your 
ignorance  in  tooth-pulling  to  entertain  such  a 
thought. 

Placing  the  lamp  on  a  table  directly  in  front 
of  the  "victim,"  you  ask  him  to  take  a  seat 
in  a  high-backed  chair;  you  discover,  however,  in 
standing  behind  him,  that  you  are  too  short  in 
stature  to  reach  over  his  head.  To  remedy  this 
you  place  a  good-sized  goods  box  on  the  floor  to 
stand  on,  one  that  was  used  by  the  druggist  in  his 
last  shipment  of  drugs  to  you;  this,  too,  fails  to 
bring  you  up  to  a  proper  height  for  operation,  so 
you  place  a  smaller  box  on  top  this  one.  This 
"fits"  exactly,  and  you  proceed  to  do  a  neat  job; 
you  find  that  your  hand  is  a  little  ' '  shaky, "  caused 
no  doubt  by  the  physical  labor  of  lifting  boxes  so 
soon  after  getting  out  of  bed. 

You  ask  the  gentleman  to  open  his  mouth  and  to 
place  his  finger  upon  the  aching  tooth.  This  he 
does,  and  you  find  it  to  be  the  last  "  molar  "  on  the 


78  HOW  TO  SUCCEED  IN 

upper  jaw;  you  at  once  slip  the  forceps  over  it  and 
clinch  with  all  your  might  and  main.  You  know 
from  its  firm  attachments  that  you  have  a  "job" 
on  your  hands.  You  tell  him  to  catch  hold  the 
rounds  of  the  chair,  when  you  begin  to  ' '  tug  and 
pull,  sweat  and  fume."  Great  beads  of  perspira- 
tion stand  out  on  your  forehead,  you  hold  your 
breath  and  pull  with  the  power  of  Hercules,  but 
not  a  ' '  jot  or  tittle  "  does  the  tooth  move.  Hold- 
ing the  forceps  with  one  hand  while  you  spit  on 
the  other,  you  again  begin  the  attack.  You 
press  back  his  head  and  place  your  knee  on  his 
neck;  you  wriggle  and  pull  and  pull  and  wriggle 
in  this  last  attempt.  You  sweat  some  more  and 
inwardly  cuss,  but  with  this  powerful  effort  out 
comes  the  tooth;  the  boxes  "wabble"  and  you 
fall  over  on  the  floor;  the  concussion  of  the  fall 
causes  the  lamp  to  go  out,  and  you  are  left  in 
total  darkness  with  the  ' '  victim  "  and  —  the  tooth. 
Relighting  the  lamp,  you  examine  the  extracted 
molar  while  the  farmer  rinses  his  mouth  with 
water — when,  ' '  lo  and  behold, "  you  have  pulled — 
the  wrong  tooth.  Quickly  slipping  it  into  your  vest 
pocket,  the  patient  asks  the  amount  of  the  fee,  you 
tell  him  fifty  cents,  which  he  pays  and  takes  his 
departure.  You  go  home,  quoting  to  yourself 
that  old  adage,  ' '  Where  ignorance  is  bliss,  'tis  folly 


THE  PRACTICE  OF  MEDICINE  79 

to  be  wise, "  and  apply  it  to  the  good  farmer  who 
had  his  tooth  drawn. 

The  next  Sunday,  as  the  contribution-box  is 
passed  around,  you  drop  into  it  a  fifty-cent  piece, 
and  the  deacon's  eyes  expand  on  witnessing  such 
liberality  on  the  part  of  the  "new  doctor."  He 
will  never  know  from  what  source  it  came,  or  why 
it  was  dropped  into  the  contribution-box. 

In  your  ministrations  you  will  occasionally  run 
across  what  is  known  and  recognized  as  an  old 
maid.  Is  it  not  queer  that  such  a  one  is  so  often 
criticised,  and  that,  too,  for  virtues  and  qualities 
that  are  commendable?  She  is  said  to  be  so 
"neat,"  so  "precise,"  so  "prim";  why,  bless  your 
soul — you  critic — would  you  have  her  to  be 
"dirty,"  not  "precise" — "slouchy,"  not  "prim"? 
Why,  then  you  would  talk  about  her  all  the  more. 
You  say  she  takes  up  all  of  her  time  in  attending 
societies:  "Ladies'  Aid  Society,"  "  Society  for  the 
Prevention  of  Cruelty  to  Animals, "  ' '  The  Society 
to  Rescue  Fallen  Women, "  ' '  Children's  Aid  So- 
ciety," etc.  Did  not  Christ  say,  "take  care  of  all 
these,"  and  is  she  not  doing  it?  Oh,  shame,  you 
mothers,  who  instill  into  the  minds  of  your  daugh- 
ters that  they  must  not  be  like  one  of  these.  You 
have  yourselves  to  blame  for  the  ill-matched 
marriages  of  your  offspring  and  the  degradation 


80  HOW  TO  SUCCEED  IN 

that  follows  all  such.  You,  who  compel  your 
daughter  to  be  a  debutante  at  seventeen,  when 
she  should  yet  be  at  school  or  learning  a  trade 
at  which  she  could  make  a  living;  you  fill  her 
mind  full  of  ' '  trash  "  and  call  it  smartness,  and 
make  her  fume  her  young  life  away  in  order  to 
meet  the  demands  of  your  so-called  society.  In 
three  years'  time  her  little  race  is  run,  and  she  is, 
mayhap,  married  to  some  pretense  of  a  man,  or  is 
retired  at  this  early  age  from  the  stage  of  action  in 
order  that  others  may  take  her  place.  No,  doctor; 
do  not  look  upon  the  ' '  old  maid  "  with  disdain,  nor 
treat  her  with  incivility,  for  she  will  be  to  you  a 
handmaiden  in  your  work  in  the  slums  and 
alleys,  hunting  out  and  administering  to  God's 
poor. 

The  serious  and  responsible  side  of  your  pro- 
fession will  come  on  you  some  day  in  a  way  that 
had  never  occurred  to  you  before.  We  will  instance 
it  as  follows  :  Among  the  many  acquaintances  and 
friends  that  you  have  made  since  locating  in  this 
pleasant  country  town  is  one  special  family  to 
which  both  you  and  your  wife  have  become  greatly 
attached;  you  have  both  concluded  that  members  of 
this  family  seem  more  congenial  in  every  way  than 
others,  and  you  are  delighted  to  count  them  your 
associates  and  friends.  We  will  say  that  the  family 


THE  PRACTICE  OF  MEDICINE  8 1 

consists  of  father,  mother,  one  son,  aged  twenty- 
two,  and  one  daughter,  eighteen  years  of  age;  the 
daughter  is  specially  attractive,  bright,  exceedingly 
pretty  and  vivacious.  She  is  by  all  odds  the  belle 
of  the  neighborhood;  her  father  has  been  able  to 
give  her  many  special  advantages,  being  a  man 
counted  "well  off"  for  this  community.  The 
girl  spent  the  past  year  at  a  boarding-school 
somewhere  up  in  the  Virginia  mountains.  She  has 
a  great  deal  of  company,  for  both  the  girls  and  boys 
for  miles  around  are  proud  to  call  her  friend; 
the  young  men  vie  with  each  other  in  paying 
her  court.  You  attended  her  upon  one  occasion — 
they  being  now  your  patrons — through  a  spell  of 
illness,  and  was  impressed  by  her  modesty  and 
good,  common  sense.  She  belongs  to  your  wife's 
4 '  Sunday-school  "  class,  and  you  have  often  heard 
her  speak  of  the  womanly  and  Christian  qualities 
of  this  girl.  One  day  you  meet  the  mother  on  the 
street  and  she  tells  you  that  "daughter"  is  not 
well;  that  she  has  noticed  for  some  time  that  her 
spirits  are  not  the  same,  but  as  no  advice  is  asked 
you  give  none. 

Shortly  afterward  the  mother  drops  in  at  your 
office  to  talk  to  you  about  her  daughter's  condition, 
and  asks  for  a  prescription;  you  see  but  little  in  the 
case  after  hearing  its  history,  and  suggest  that  the 


82  HOW  TO  SUCCEED  IN 

young  lady  take  more  exercise  in  the  fresh  air,  and 
prescribe  a  simple  tonic  to  ' '  tone  "  her  up  and  bring 
back  her  appetite.  Time  goes  on  and  the  young 
lady  does  not  improve,  and  you  are  asked  to  go 
out  and  see  her,  ' '  not  that  she  is  much  sick,  but 
'  mother '  would  be  better  satisfied. "  In  the  next 
few  days  you  are  busy  and  do  not  pay  the  promised 
visit,  but  on  the  fourth  day  you  go  out  to  see  this 
charming  girl.  You  are  surprised  at  her  pale  face, 
anxious  expression,  and  nervous  manner;  so  foreign 
are  these  to  this  usually  bright  and  ruddy-complex- 
ioned  girl  that  you  are  forced  to  the  opinion  that 
she  must  be  really  sick.  After  questioning  her  you 
come  to  the  conclusion  that  an  examination  is  nec- 
essary. Let  me  stop  here  long  enough  to  say  to 
the  young  men  in  the  profession  who  may  read  this 
book:  Do  not,  I  beg  of  you,  get  in  the  habit  of  mak- 
ing examinations  of  young  girls  whom  you  may 
suspect  of  having  some  uterine  disease.  Such  a 
procedure  is  seldom  required  and  generally  is  un- 
warrantable, if  not  outrageous,  on  the  part  of  the 
doctor  who  does  it.  Respect  the  sex  to  which  your 
mother  and  sister  belong,  and  do  no  unnecessary 
thing  that  will  bring  a  blush  of  shame  to  the  cheek 
of  young  maidenhood. 

You  are  convinced  that  an  examination  is  neces- 
sary, and  after  explanations  and  some  entreaties 


THE  PRACTICE  OF  MEDICINE  83 

on  the  part  of  the  good  mother,  the  young  patient 
gives  her  reluctant  consent. 

The  examination  is  completed;  you  put  on  your 
hat  and  walk  out  into  the  woods  in  order  to  think 
and  commune  with  yourself.  The  grass  is  green 
under  your  feet  and  the  vault  of  heaven  over 
your  head  is  as  clear  and  blue  as  the  noonday's 
sun  can  make  it;  the  birds  in  the  trees  chirp 
merrily  to  each  other,  and  all  nature  seems  full 
of  cheer  and  is  so  beautiful.  More  akin  to  your 
thoughts  would  it  be  if  the  clouds  lowered,  the 
thunders  pealed,  the  lightnings  flashed,  and  the 
rain  poured  down  in  torrents,  for  is  there  not  just 
within  the  door  of  this  happy  home  a  storm  ap- 
proaching that  would  put  such  a  one  of  the  elements 
to  shame?  Is  there  not  a  young  spirit  calling  out 
from  the  depths  of  despair,  ' '  Save  me,  save  me ! " 
How  can  the  heavens  be  bright  this  day  and  all 
nature  aglee  if  God  be  merciful  ?  Think  well,  doc- 
tor, think  long  and  well;  you  are  now  facing  the 
one  condition  that  involves  more  than  all  others  with 
which  you  will  have  to  deal:  A  mother's  broken 
heart,  a  father's  affection  and  pride,  a  brother's 
young  manhood  and  future  prospects,  a  beautiful 
and  good  (yes,  verily,  good)  girl's  life  and  character 
—  the  life  of  one  unborn — all,  all  these  depend 
now  upon  your  action. 


84  HOW  TO  SUCCEED  IN 

Was  ever  man  put  to  a  more  severe  test?  Was 
ever  a  moment  that  required  such  quick  and  accu- 
rate thought?  Was  ever  greater  responsibility 
thrown  upon  man?  Go  to,  you  moralists,  and  be- 
gone you  chattering  women  who  would  consign  this 
innocent  (yes,  innocent)  girl  to  eternal  oblivion  and 
earthly  disgrace  because  of  this  one  act,  engen- 
dered and  born  of  love  and  trust.  Get  you  to 
your  dens,  you  who  point  the  finger  of  scorn  at 
her  and  are  not  worthy  to  wipe  her  feet  because 
of  your  own  sins  and  transgressions.  Pluck  the 
cinder  out  of  your  own  eye,  oh !  you  carping  hypo- 
crite and  tattling  mountebank  before  you  dare  call 
this  girl  —  unchaste.  You  who  assemble  yourselves 
together  and  style  the  rank  thing  society,  look  to  it 
that  your  own  daughters  are  free  from  taint 
before  you  begin  the  act  of  kicking  this  poor 
girl  out  and  pile  anathemas  upon  her  head; 
you  who  court,  and  on  bended  knee  beseech 
attention  for  your  children  from  men  who  are 
moral  lepers  and  reeking  with  sores  of  putre- 
faction and  filth.  For  the  sake  of  Mammon 
you  are  willing  that  these  leprous  vipers  take 
your  young,  unsuspecting  daughters  into  their 
very  arms,  and  by  their  breath  or  a  touch  of  their 
polluting  lips  doom  them  to  an  early  grave.  "  Oh 
pity  'tis,  'tis  true."  Knowing  this  as  you  do,  may 


THE  PRACTICE  OF  MEDICINE  85 

the  putrid  bodies  and  decaying  bones  of  your 
daughters  haunt  you  and  make  you  afraid. 

I  leave  the  case  for  your  proper  management, 
doctor,  and  my  pity  goes  out  to  you  as  one  brother 
for  another.  Remember  only  that  by  no  authority 
are  you  empowered  to  sacrifice  a  human  life,  for 
life  you  have  not  given  and  life  you  must  not  take 
away. 

You,  no  doubt,  have  been  congratulating  yourself 
for  some  time  that  no  case  yet  in  your  practice 
has  called  for  consultation.  In  this  connection 
I  desire  to  offer  a  few  words  of  advice.  A  consul- 
tation with  an  honest,  intelligent  physician  should 
never  be  looked  upon  other  than  as  a  pleasant 
and  profitable  thing.  I  never  could  quite  under- 
stand why  some  doctors  object  so  to  meeting  their 
professional  friends  in  the  consulting-room.  It 
may  be  that  they  fear  an  exposure,  either  of  their 
diagnosis  or  treatment.  It  may  be  that  they  fear 
that  the  impression  might  go  out  that  they  were  not 
competent  to  meet  the  emergency  or  manage  the 
case.  It  may  be  that  such  a  one  is  possessed  of  a 
large  cranium  and  little  in  it,  yet  believes  that  he 
"knows  it  all,"  or  it  may  be  that  he  has  "soured" 
on  the  world  and  looks  with  suspicion  upon  all 
mankind,  including  his  medical  brethren,  with 
whom  he  ought  to  be  in  close  touch  and  sympathy. 


86  HOW  TO  SUCCEED  IN 

If  any  of  these  possess  your  soul,  doctor,  you  are 
wrong  for  many  reasons: 

First.  It  is  a  duty  that  you  owe  your  patient. 
When  life  or  health  is  at  stake  there  should  be  no 
quibbling,  but  the  Golden  Rule  should  be  followed 
strictly.  The  patient  when  he  employs  you  does  so 
with  the  understanding  that  you  will  do  everything 
in  your  power  for  his  relief.  Just  as  a  man  expects 
his  executor  to  fulfill  his  every  duty  after  he  is 
dead,  so  this  patient,  realizing  that  he  may  pass 
into  an  unconscious  condition  and  be  mentally 
dead,  trusts  you  to  do  your  whole  duty  to  him.  If 
at  any  time  during  his  illness  you  recognize  that 
danger  threatens  or  that  you  are  unable  to  cope 
with  the  disease  you  should  at  once  ask  for  con- 
sultation. 

Second.  If  at  any  time  during  the  progress  of 
the  case  the  family  become  alarmed,  even  unnec- 
essarily, another  doctor  should  be  called  in  the  case. 

Third.  If  you  are  seriously  concerned  about  the 
condition  of  the  patient  and  find  that  you  have  not 
the  amount  of  time  to  give  the  case  the  attention 
it  requires,  another  should  be  called,  in  order 
that  proper  attention  can  be  afforded. 

Fourth.  If  you  know  that  it  is  a  case  wherein 
you  are  inexperienced,  one  should  be  called  who 
has  had  the  necessary  experience. 


THE  PRACTICE  OF  MEDICINE  87 

Fifth.  If  it  is  such  a  condition  as  does  not 
belong  to  the  province  of  the  general  practitioner, 
and  you  have  not  been  specially  instructed  in  cases 
of  the  kind,  a  specialist  should  be  called.  You 
have  not  performed  your  full  duty  to  the  patient 
if  you  have  neglected  any  one  of  these.  In  his 
condition  of  sickness,  delirium,  etc. ,  the  patient  is 
unable  to  suggest;  it  is  therefore  plainly  your  duty 
to  think  and  act  for  him.  It  should  be  an  act  of 
pleasure  to  do  so,  and  not  regarded  in  any  other 
light.  Think  of  a  case  of  serious  import  when  you 
have  spent  whole  days  and  nights  in  racking  your 
brain  and  tiring  your  body  in  your  effort  to  save 
life;  how  pleasing,  indeed,  would  it  be  to  have 
another  to  consult  with,  if  for  nothing  else,  to  share 
this  great  responsibility.  Then,  too,  often  the 
simplest  suggestion  will  be  of  incalculable  good. 

I  remember  that  upon  a  certain  occasion,  one 
that  was  close  to  me  by  the  ties  of  blood  was  dan- 
gerously ill  with  what  seemed  to  be  an  acute  ulcer 
of  the  stomach.  He  had  employed  one  of  the  best 
and  most  cultured  physicians  in  the  State,  who  had 
been  constant  in  his  attentions  and  who  had  ex- 
hausted every  remedy  within  his  knowledge.  An- 
other— elder  physician  —  was  called  in  consultation, 
and  suggested  the  use  of  one  drop  of  carbolic  acid 
in  dilution;  that  one  drop  saved  the  patient's  life. 


88  HOW  TO  SUCCEED  IN 

Think  of  being  in  a  case  when  death  is  imminent 
from  hemorrhage,  and  you  are  not  able  to  control 
it,  would  it  not  gladden  your  heart  to  see,  coming 
over  the  hill,  a  brother  practitioner  in  whom  you 
had  faith?  You  may  urge  the  objection  that  you 
are  not  on  ' '  friendly  terms  "  with  the  doctor  across 
the  way,  and  therefore  can  not  consult  with  him. 
Then  permit  me  to  suggest  that  you  go  over  and 
make  friends  with  him.  This  thing  of  doctors  in 
every  little  town  being  at  enmity  with  each  other 
is  a  disgrace  to  the  profession  and  should  be 
stopped.  It  has  become  proverbial  that  if  a  vil- 
lage has  within  its  borders  three  physicians,  two  of 
them  do  not  speak  to  each  other.  This  is  a 
shameful  condition  of  affairs,  and  brings  the  profes- 
sion into  constant  ridicule.  Nine  times  out  of  ten 
it  will  be  found  that  this  enmity  has  been  excited 
by  common  gossip,  and  that  there  is  not  a  syllable 
of  truth  in  the  statement  which  has  separated  two 
friends  and  made  them  enemies.  Go  to  him,  and 
you  will  find,  upon  investigation,  that  he  has  just 
as  much  reason  to  be  offended  at  you  as  you  have 
to  be  offended  at  him.  Truth  is,  that  both  of  you 
have  acted  the  part  of  fools  and  deserve  a  severe 
reprimand;  shake  hands,  make  up,  and  treat  each 
other  as  gentlemen  in  the  future.  Listen  no  more 
to  idle  tales,  gossipy  tongues,  and  consummate 


THE  PRACTICE  OF  MEDICINE  89 

liars.  If  he  is  no  gentleman,  will  not  make  up, 
and  persists  in  his  offensive  course,  either  thrash 
him  or  forever  let  him  go  his  way.  The  chief  and 
whole  object  in  a  consultation  is  to  benefit  the 
patient. 

As  I  am  speaking  alone  to  doctors,  let  me  be 
frank  and  say,  that  although  a  life  may  hang  in  the 
balance  many  consultations  are  absolute  frauds  and 
farces.  You  call  a  brother  doctor  to  see  a  case 
with  you,  and  in  some  instances  at  least,  he,  for 
fear  of  offending  you,  will  agree  to  your  course  of 
treatment  when  at  heart  he  believes  that  you  are 
pursuing  the  wrong  course.  This  is  politeness 
personified  and  carried  to  an  extreme  that  should 
receive  positive  censure.  Remember,  whenever 
you  are  the  consultant,  that  the  patient  sends  for 
you  believing  that  his  life  or  health  is  in  danger 
and  he  cries  out  to  you  for  help.  Be  honest,  but 
not  offensive ;  say  and  act  the  truth,  for  this  is  your 
bounden  duty. 

No  true  man  in  our  profession  is  going  to  feel 
himself  hurt  by  a  consultant  acting  up  to  his  prin- 
ciples and  belief.  The  part  of  a  consultant  is  often 
a  difficult  one  to  fill;  you  must  treat  the  attending 
physician  with  great  civility,  and  be  just  to  him  as 
well  as  to  the  patient.  What  despicable  characters 
these  are,  calling  themselves  doctors,  puffed  up 


QO  HOW  TO  SUCCEED  IN 

with  their  own  greatness,  who  go  into  a  case,  called 
by  the  attending  physician,  and  with  a  supercilious 
smile,  or  a  knowing  wink,  or  a  nod  of  the  head 
tries  to  impress  others  with  his  greatness  (alleged) 
and  to  underrate  his  brother  doctor.     They  are 
better  suited  to  call  off  prizes  at  a  baby  show,  or 
to  hawk  patent  medicines  on  the  street  corner  than 
to  practice  medicine.   Thank  goodness,  there  are  but 
few  of  this  kind  in  the  medical  profession,  and  they 
are  generally  known  and  receive  their  just  reward. 
This  particular  class  may  really  have  talent,  and  if 
stripped  of  their  pompousness  and  self-conceit  would 
be  acceptable  practitioners  of  medicine.     There  is 
another  "character"  that  you  will  sometimes  meet 
in  consultation  because  you  will  \>z  forced  to  do  so. 
I  allude  to  the  illiterate  old  fellow  who  is  known  as 
an  herb  or  ' '  yarb  "  doctor.     He  does  not  claim  any 
book  "laming,"  or  to  be  much  in  anatomy,  physi- 
ology, or  any  of  the  allied  branches.      In  fact,  he 
would  be  puzzled  to  answer,  if  you  were  to  ask  him, 
whether  the  liver  is  in  the  abdominal  cavity  or  in 
the  chest.     He  simply  claims  to  know  that  certain 
"yarbs"  act  in  a  certain  way  upon   the  human, 
and  it  may  be  he  is  right.     He  is,  be  it  said  to  his 
credit,   inoffensive;  at  least  his  "yarbs"  are,  and 
he  is  much  to  be  preferred  to  the  man  with  a  knife 
always  ready  to  cut  into  cavities,  with  the  contents  of 


THE  PRACTICE  OF  MEDICINE  91 

which  he  is  unfamiliar,  or  the  ' '  regular  "  that  will 
administer  a  medicine  the  dose  of  which  is  un- 
known to  him,  and  which  may  have  a  fatal  effect. 
This  old,  rugged,  illiterate,  but  honest  doctor  (?) 
is  well  described  by  Dr.  Willis  P.  King  in  his 
"Humors  of  the  Medical  Profession,"  viz.:  "I 
always  dreaded  the  hour  that  would  bring  me  in 
consultation  with  the  old  doctor,  but  it  came  at 
last.  I  was  attending  a  very  sick  lady  patient,  when 
it  was  suggested  that  they  have  in  consultation  old 
Dr.  Sawbones.  He  had  been  practicing  in  this 
county  for — well,  always.  Of  course  I  consented, 
but  with  fear  and  trembling.  I  expected  to  hear  a 
long  discourse  on  the  pathological  aspect  of  the 
case,  and  many  other  things  which  would  confound 
me.  He  came,  with  breeches  in  boots  and 
spectacles  on  nose.  He  listened  attentively  while 
I  recited  the  history  of  the  case,  and  when  I  finished 
he  said  with  great  dignity :  '  Did  you  ever  try 
a  black  cat-skin  poultice  in  such  a  case?'  In 
my  ignorance,  I  confessed  that  I  never  had.  I  saw 
a  good  opportunity  to  escape  from  the  case,  so  I 
told  the  family  that  inasmuch  as  the  old  doctor 
had  known  them  so  long,  that  it  would  be  best  for 
him  to  take  charge  of  the  patient.  They  consented, 
and,  I  could  see,  with  a  great  deal  of  pleasure. 
That  was  an  awful  night  on  cats,  especially  on 


92  HOW  TO  SUCCEED 

black  cats.  Of  course  the  patient  died,  but  he  told 
them  that  if  he  had  been  called  a  '  leetle '  sooner, 
and  had  succeeded  in  getting  a  '  leetle  blacker  cat '  he 
could  have  saved  her  life  —  and  they  believed  him. " 
It  is  a  most  singular  fact  that  men  who  have 
great  business  capacity,  who  possess  more  than  an 
ordinary  amount  of  brains,  are  of  good  perception, 
and  acute  in  their  knowledge  of  men;  who,  if  they 
desired  to  purchase  a  town  lot,  would  employ  a 
lawyer  whom  they  knew  possessed  ability,  in  order 
that  they  might  be  sure  the  ' '  deed  "  was  right,  will, 
if  the  family  is  sick  near  unto  death,  employ  the 
worst  of  quacks  or  the  loudest-mouthed  charlatan. 
This  is  a  mystery  past  rinding  out.  Then,  too,  it 
is  clear  to  every  observant  person  that  the  laity 
often  fail  in  judgment  whenever  the  selection  of  a 
doctor  is  necessary.  It  would  seem  that  the  same 
rule  that  would  obtain  in  judging  the  ability  of  a 
lawyer,  minister,  or  harness-maker  would  apply  to 
the  doctor,  yet  every  day  we  see  evidence  of  the 
fact  that  the  reverse  of  this  is  true.  In  other  learned 
professions  proficiency  and  learning  are  made  abso- 
lutely necessary  qualities  by  the  laity  for  recognition, 
but  we  see  men  in  the  medical  profession  who  can 
not  lay  claim  to  either  doing  enormous  practices. 
I  am  sorry  to  chronicle  the  fact  that  true  merit  does 
not  always  insure  success  in  the  practice  of  medicine. 


CHAPTER  VI 

SPECIALTIES  IN  MEDICINE 

During  the  past  decade  the  innovation  of  special- 
ism has  grown  to  enormous  proportions.  In  the 
past  few  years  there  has  been  a  slight  reaction  in 
that  it  has  been  argued  that  some  specialties  natu- 
rally belong  to  a  larger  field,  or  that  the  general 
practitioner  should  embrace  them  all,  or  part,  by 
becoming  proficient  in  the  different  lines.  We  must 
all  admit  that  the  one  great  "specialty"  is  the 
general  practice  of  medicine,  and  the  nearest  ap- 
proach to  perfection  is  to  be  found  in  the  person 
of  the  honest,  capable,  and  well-prepared  "coun- 
try doctor."  From  the  drawing  of  a  tooth  to  the 
cutting  off  a  leg;  from  prescribing  for  a  simple 
' '  belly-ache  "  to  treating  a  long-continued  case  of 
typhoid  fever;  from  extracting  an  ingrown  toe- 
nail  to  saving  life  in  a  case  of  postpartum  hemor- 
rhage, is  his  daily  routine.  He  combines  all  spe- 
cialties in  his  work.  His  responsibility  is  tenfold, 
or  in  proportion  to  the  number  of  specialties,  and 
his  knowledge  should  be  in  the  same  positive  ratio. 
When  it  comes  to  a  division  of  labor,  we  have  first, 
surgeon  and  physician  —  the  practice  of  surgery 
and  the  practice  of  medicine.  This  comes  as  a 


94  HOW  TO  SUCCEED  IN 

natural  sequence,  for  it  must  be  admitted  that 
there  are  most  excellent  physicians  who  lay  no 
claim  to  the  knowledge  of  surgery,  or  its  practice 
may  be  distasteful  to  them.  It  can  not  be  denied, 
either,  but  that  it  requires  some  special  tact,  some 
indefinable  delicacy  of  touch,  some  special  capacity 
to  use  the  knife  outside  of  one's  ability  to  acquire 
knowledge.  Even  among  surgeons  there  are  some 
that  are  more  expert  than  others,  and  to  whom  the 
palm  is  given.  A  man  might  be  a  splendid  teacher 
of  surgery  and  yet  a  poor  surgeon,  and  this  applies 
as  well  to  medicine.  So  there  are  great  and  accom- 
plished surgeons  who  could  not  impart  their  knowl- 
edge, nor  could  they  succeed  in  the  general  practice 
of  medicine. 

It  is  well  that  we  have  special  talents  that  fit 
one  for  separate  callings,  for  the  field  is  too  large 
to  be  covered  by  one  mind  and  the  demands  too 
exacting  to  create  such  desire.  These  reasons  are 
quite  sufficient  to  call  for  the  distribution  of  labor 
between  the  physician  and  surgeon,  but  there  are 
others  equally  as  forcible,  to  wit,  a  physician  in  his 
busy  field  runs  amuck  of  conditions  and  diseases 
that  would  imperil  lives  were  he  to  meet  many 
emergency  cases  of  surgery,  and  vice  versa;  the 
surgeon  would  run  the  risk  of  many  a  life  should  he 
go  from  the  operating-table  to  the  bedside  of  the 


THE  PRACTICE  OF  MEDICINE  95 

sick.  You  might  say,  Could  they  not  disinfect  or 
render  themselves  aseptic?  Yes,  possibly  so,  but 
have  they  the  time  or  inclination?  But  the  lines 
are  well  drawn,  and  will  remain  so,  and  it  is  useless 
to  argue.  But  you  will  possibly  ask,  Are  there  just 
as  palpable  reasons  for  the  existence  of  the  other 
specialties?  I  am  inclined  to  answer  you  in  the 
affirmative,  at  least  in  regard  to  most  of  them. 

Now,  it  must  be  distinctly  understood  that  when 
I  speak  of  specialists  I  do  not  allude  to  the  mush- 
room, the  inexperienced,  the  pseudo-specialist,  who 
has  grown  up  in  a  day,  or  the  man  who  ' '  blooms " 
out,  as  it  were,  from  school  or  from  the  general 
practice  of  medicine.  He  has  no  claims  above  his 
fellow-practitioners,  and  it  is  an  insult  to  them  for 
him  to  be  so  proclaimed.  But  it  is  to  the  man  who 
was  a  successful  and  competent  practitioner  of  gen- 
eral medicine,  who,  after  work  in  this  field  for  a 
number  of  years  (it  should  not  be  less  than  five) 
discovers  that  he  has  special  talent,  and  devotes 
the  proper  time  in  hospitals  with  men  who  are 
competent,  in  the  laboratories,  at  the  bedside  with 
the  knife  in  hand,  and  sufficient  study  to  fit  the  case. 
This  man,  who  is  willing  to  make  a  sacrifice  of  his 
general  practice  and  become  a  beginner  again,  he 
is  the  deserving  specialist,  and  none  other;  and  it 
is  to  him  I  allude  in  my  reference  to  specialists.  In 


96  HOW  TO  SUCCEED  IN 

this  connection  I  desire  to  say  that  the  post-gradu- 
ate schools  of  the  country  are  more  or  less  respon- 
sible for  the  /^^^-specialist.  Inducements  are 
held  out,  and  when  men  respond  from  all  over  the 
country  who  desire  to  become  specialists,  they  are 
permitted  to  see  a  few  operations  and  hear  a  few 
lectures,  and  at  the  end  of  a  six  weeks'  or  three 
months'  term  are  allowed  to  return  home  imbued 
with  the  idea  that  they  have  sufficient  learning  and 
experience  (?)  to  become  such.  This  is  a  mistake 
on  the  part  of  these  colleges.  No  certificates  of 
attendance  should  be  given  to  any  one  who  has 
not  convinced  the  faculty  that  he  is  proficient  in 
certain  branches,  and  the  term  should  be  ex- 
tended to  a  sufficient  length  of  time  to  impart 
such  knowledge. 

To  continue  the  discussion:  Is  it  necessary  for 
the  welfare  of  the  people  to  have  other  specialties 
outside  the  division  of  the  field  of  medicine  and 
surgery?  Other  specialties  are  but  the  hand- 
maidens of  the  mother  specialty  —  general  medi- 
cine— and  should  not  be  looked  upon  with  either 
envy  or  distrust.  If  there  was  no  need  for  them 
they  would  and  could  not  live.  It  is  the  same  with 
them,  as  a  class,  as  with  the  great  rule  that  con- 
trols the  universe  —  "the  survival  of  the  fittest," — 
nor  does  the  existence  of  these  specialties  in  any 


THE  PRACTICE  OF  MEDICINE  97 

way  interfere  with  the  general  practitioner,  if  viewed 
in  their  proper  light.  It  is  the  so-called  specialist, 
not  the  specialty,  that  does.  There  are  men  claim- 
ing to  do  special  work  who  attempt  the  doing  of 
any  kind  of  work,  under  the  shield  and  protection 
of  the  name  they  assume.  This  is  an  injustice  to 
other  men;  is  a  false  claim,  and  any  one  guilty  of 
such  conduct  should  be  ferreted  out  and  tabooed. 
Any  man  has  the  rieht  to  do  any  manner  of  prac- 
tice that  he  desires,  but  let  him  be  honest  and  say 
so.  Let  us  consider  the  different  specialties  in 
detail,  and  let  us  see  if  what  I  have  said  is  true. 
Is  the  average  practitioner  of  medicine  able,  or 
does  he  care,  to  do  a  hysterectomy,  extract  a  cata- 
ract, treat  the  intricate  channels  of  the  ear,  lay 
open  the  many  sinuses  consequent  on  the  existence 
of  a  stricture  of  the  urethra  and  eradicate  the 
stricture  by  the  proper  operation;  deal  with  the 
many  phases  of  obscure  brain  or  nerve  trouble, 
fight  the  obstinate  affections  of  the  stomach  caused 
by  a  true  pathology,  or  resect  a  rectum  ?  Put  them 
all  together,  and  do  you  not  assent  that  if  there 
were  not  men  who  paid  special  attention  to  these 
troubles  they  would  either  go  untreated  or  unre- 
lieved? Altogether,  there  would  be  but  few  cases 
observed  in  a  year  by  the  general  practitioner;  so 
financially  he  is  not  injured,  and  if  he  desired  to 


98  HOW  TO  SUCCEED  IN 

treat  them  he  has  not  prepared  himself  to  do  so 
or  equipped  himself  for  the  work. 

The  specialist,  by  his  known  reputation,  has  one 
patient  from  this  source,  another  from  that,  with 
the  whole  Union  to  draw  from,  and  by  putting  them 
together  he  has  a  sufficient  number  to  constitute  a 
practice,  without  in  the  least  injuring  any  general 
practitioner.  Then  it  must  be  agreed  that  having 
spent  sufficient  time  and  money  to  become  profi- 
cient, the  number  of  cases  that  he  sees  gives  him 
the  advantage  of  experience  over  the  man  who  only 
by  chance  sees  one  occasionally.  It  might  be  asked 
if  it  is  not  in  the  power  of  the  general  practitioner 
to  master  the  work  of  the  specialist?  I  would 
answer  yes,  certainly,  he  is  the  very  best,  the  only 
material  of  which  specialists  should  be  made,  after 
he  has  followed  the  proper  lines.  But  you  may 
mean  to  ask,  ' '  Can  he  not  master  all  the  special- 
ties?" Well,  yes,  if  he  could  live  long  enough; 
but  life  being  short,  and  being  made  up  of  "  seven 
ages, "  he  would  arrive  at  that  one  of  ' '  sans  teeth, 
sans  eyes,  sans  taste,  sans  everything,"  before 
he  had  done  so,  which  would  leave  him  no  time  to 
execute  that  which  he  had  planned. 

It  may  be  that  you  contemplate  taking  up  a  spe- 
cialty. If  so,  it  would  be  my  great  pleasure  to  aid 
you,  if  I  can,  by  a  few  friendly  suggestions.  Hav- 


THE  PRACTICE  OF  MEDICINE  99 

ing  been  in  the  medical  profession  for  thirty-five 
years,  and  a  specialist  for  twenty-five,  it  might  not 
be  amiss  for  me  to  venture  to  do  so.  In  the  first 
place,  in  the  language  of  our  good  Presbyterian 
brethren, ' '  Do  you  feel  thatyou  are  called  to  preach, 
teach,  and  practice  a  specialty?  "  Do  not  be  actu- 
ated, no  more  than  the  young  man  called  to  preach 
the  gospel,  by  a  desire  to  make  money,  but  by  a 
feeling  that  you  could  do  much  good  in  a  certain 
line;  the  money  may  come  to  you  in  good  season. 
Having  practiced  general  medicine  for  at  least  Jive 
years,  you  are  ready  to  begin  the  study  of  some 
special  class  of  diseases.  The  man  who  has  not 
studied  the  manifestation  of  disease  in  its  many 
general  phases  in  the  field  as  a  general  practitioner 
is  not  fit  material  to  make  a  specialist  out  of.  This 
is,  or  should  be,  the  foundation  upon  which  spe- 
cialism is  builded,  and  without  it  you  would  be 
constantly  making  all  manner  of  mistakes.  I  take 
it  for  granted  that  you  have  selected  the  one  branch 
which  you  prefer.  There  are  several  courses  left 
for  you  to  pursue.  I  would  suggest  the  following: 
Ascertain  the  name  of  a  man  learned  and  active  in 
that  line,  and  try  to  get  the  opportunity  of  a  year's 
observation  in  his  office.  If  you  succeed  in  this 
you  will  have  the  chance  for  much  reading,  regular 
training,  the  seeing  of  actual  work,  and  possibly  the 


100  HOW  TO  SUCCEED  IN 

chance  to  operate  upon  patients  yourself.  After 
this  year  is  spent  in  close  application,  go  to  some 
city  that  offers  special  advantages  in  that  line, 
either  in  the  way  of  college  training  or  in  a  private 
class;  there  are  plenty  of  them,  and  you  need 
make  no  mistake.  Try  and  become  associated 
with  some  hospital  or  clinic  where  you  can  see  and 
do  much  clinical  work.  After  this  year  has  passed 
you  might  run  over  to  Paris,  London,  Berlin,  or 
Vienna,  one  or  all,  and  see  if  the  methods  there 
are  different.  Six  months  will  be  sufficient  for 
this.  Upon  your  return  select  some  city  of  not 
less  than  twenty-five  thousand  inhabitants,  hang 
out  a  modest  sign,  simply  with  your  name  on  it  — 
no  "limited  to — "  and  begin  practice,  and  I  hope 
for  you  abundant  success. 

MEDICAL  SOCIETIES. 

What  I  shall  say  throughout  this  book  will 
apply  to  the  practice  of  medicine,  whether  it  be 
by  the  physician,  surgeon,  or  specialist.  In  locat- 
ing, you  should  inquire  very  soon  if  a  medical 
society  exists  in  the  town  or  county.  If  so,  you 
should  not  waste  time,  but  apply  for  admission, 
and  being  received,  become  an  active  member. 
This  will  accomplish  several  things: 


THE  PRACTICE  OF  MEDICINE  IOI 

First.  It  will  afford  you  an  opportunity  of 
getting  acquainted  with  the  ' '  other "  doctors.  A 
man  that  lives  to  and  for  himself  alone  has  no  busi- 
ness in  the  medical  profession.  Get  acquainted, 
not  only  with  the  people,  but  with  the  doctors. 
You  are  engaged  in  the  same  laudable,  merciful 
calling.  Talk  of  the  ties  that  bind  together  the 
secret  societies  of  the  world — that  which  should 
and  does  exist  between  members  of  the  medical 
profession  outshines  them  all, 

True,  there  are  sometimes  dissensions  in  our 
ranks,  but  they  are  trivial  and  come  only  at  long  in- 
tervals. The  main,  true  object  is  never  lost,  and 
we  are  brethren  indeed.  Let  your  child  or  mine  be 
stricken  down  on  some  far-distant  shore,  and  the  in- 
formation flashed  over  the  wire  that  he  is  the  son  of 
a  doctor,  how  promptly  and  willingly  is  he  attended 
by  another  doctor  without  remuneration  save  that 
of  the  pleasure  it  gave  of  having  served  a  fellow 
doctor.  Let  your  child,  or  you  yourself,  be 
stricken  at  midnight  with  some  fearful  malady, 
and  though  the  night  is  dark  and  the  storm  rages 
without  your  brother  physician  will  come  to  you 
though  drenched  with  rain  or  pelted  with  hailstones. 
Then  say  to  me  that  doctors  are  selfish  or  devoid 
of  sympathy!  It  may  be  that  the  society  will  some 
night  give  a  ' '  banquet. "  We  sometimes  form 


102  HOW  TO  SUCCEED  IN 

opinions  of  men  from  false  premises.  When  you 
meet  around  the  ' '  board  "  and  ' '  knock  knees  " 
with  your  confreres  you  are  better  able  to  judge  of 
their  qualities,  and  it  is  sure  to  make  you  like  them 
better.  If  you  remain  at  home,  fearing  to  look 
people  in  the  face,  you  will  become  selfish,  then 
melancholy,  and  then  a  misanthrope,  hating  the 
world  and  everybody  in  it. 

Come,  come ;  this  is  the  way  to  sing  it : 

Bells  or  no  bells  ringin' 
Joy  or  gloom  in  sight, 
Might  as  well  be  singin' 
That  "The 

World's 
All 

Right." 

Never  did  complainin* 
Put  a  grief  to  flight: 
Sunny  day,  or  rainin' 
Sing  "The 

World's 
All 

Right." 
That's  the  sort  o'  singin' 

Takes  from  bloom  the  blight; 
Bells  or  no  bells  ringin' 
Think  "The 

World's 
All 

Right." 

Second.     It   will  afford  you  an  opportunity  to 
tell  them  what  you  know.     Belonging  to  this,  your 


THE  PRACTICE  OF  MEDICINE  IO3 

medical  society,  will  present  you  with  the  chance 
to  read  a  paper  on  some  medical  subject.  Be 
sure  that  you  have  given  it  careful  thought,  for 
you  are  now  to  appear  before  your  critics.  No  doubt 
but  that  they  have  discussed  you  freely  before  this 
time,  but  now  they  are  to  sit  in  judgment  upon  you; 
your  general  appearance,  your  manners,  and  pos- 
sibly your  ability  have  been  talked  over;  but  much 
of  this  came  by  hearsay,  and  now  they  have  the 
opportunity  to  judge  for  themselves.  You  are  the 
young  doctor  just  moved  to  town,  so  you  must  be 
prepared  to  run  the  gauntlet  of  public  and  private 
criticism.  Let  me  suggest  to  you  that  this  first 
"paper"  should  be  short  and  to  the  point,  and  let 
it  be  on  a  commonplace  subject,  as,  for  instance, 
' '  How  to  diagnosticate  and  treat  '  chicken-pox. ' " 
Put  this  out  as  a  feeler;  you  will  disappoint  them 
because  they  are  expecting  that  you  are  to  bore 
them  with  a  long  dissertation  on  some  pure  theo- 
retical subject.  The  essay  will  then  be  discussed, 
and  you  will  be  afforded  the  opportunity  to  close. 
Third.  It  gives  the  chance  of  listening  to  ' '  how 
much  they  know."  Not  only  does  it  do  this,  but 
likely  during  this  meeting  you  will  pick  out  the  man 
whom  you  would  trust  most  in  consultation,  or  have 
attend  you  or  your  family  if  taken  sick.  Perhaps 
you  have  noticed  in  the  assemblage  an  old,  gray- 


IO4  HOW  TO  SUCCEED  IN 

haired  doctor  who  hails  from  the  lower  end  of  the 
county,  and  who  does  not  have  his  habitation  in 
town.  Likely  he  has  been  practicing  more  years 
than  you  are  old.  It  may  be  that  he  is  dressed  in 
4 '  homespun  "  and  wears  his  pants  in  his  boots ;  his 
hands  are  rough  and  his  face  wrinkled  even  beyond 
his  years.  You  have  observed  him,  for  he  has  a 
strong  personality.  You  wonder  if  he  really  ' '  knows 
anything, "  and  if  he  is  not  one  of  these  old  country 
doctors  that  are  out  of  date  and  not  up  to  recent 
ideas  in  medicine.  If  such  have  been  your  thoughts 
you  will  be  woefully  deceived  when  he  gets  up  to 
discuss  your  paper.  It  may  be  true  that  he  does 
not  use  very  correct  or  elegant  English,  but  he  tells 
you  more  in  ten  minutes  about  ' '  chicken-pox  "  than 
you  have  learned  in  the  four  years  at  the  medical 
college.  You  are  impressed  with  his  "good  com- 
mon sense,"  and  you  are  persuaded  that  observa- 
tion and  experience  are  worth  a  great  deal  in  the 
practice  of  medicine.  You  have  the  last  "say," 
as  the  discussion  is  over,  and  you  are  asked  to 
"close  it." 

A  word  about  your  manner  and  language  "on 
the  floor":  Let  it  be  without  ostentation,  positive, 
though  never  dogmatic,  your  voice  loud  enough  to 
be  heard;  not  quick  to  answer  questions,  but  listen 
with  attentiveness,  and  let  every  gesture,  move- 


THE  PRACTICE  OF  MEDICINE  IC«5 

ment,  and  word  bespeak  the  gentleman.  Let  the 
impression  go  out  from  this  meeting  that  you  are 
great  in  simplicity,  earnest  in  purpose,  and  have 
fidelity  to  principles  of  right.  From  the  county 
society  go  to  your  State  society,  and  let  yourself 
be  heard,  modestly  but  surely.  From  the  State 
society  attach  your  membership  to  the  national 
body,  for  this  is  your  duty. 

MEDICAL  JOURNALS. 

You  will  find  much  time  during  the  first  year  to 
read,  for  it  is  not  likely  that  you  will  be  burdened 
with  practice,  and  fortunate  for  you  if  you  are  not. 
The  young  man  that  goes  into  a  large  practice  just 
after  quitting  school  is  to  be  pitied,  for  he  is  sure 
to  soon  run  into  a  groove  or  rut  from  which  he  will 
never  extricate  himself.  Far  better  that  he  should 
fail  to  make  expenses  than  to  do  this,  for  read  and 
study  he  must,  and  if  busy — too  busy  —  he  will 
not.  You  must  provide  and  surround  yourself  with 
some  sound  medical  literature;  subscribe  for  some 
medical  journals,  say  one  that  is  published  weekly, 
one  monthly,  and  a  quarterly  devoted  to  some 
special  subjects.  Around  your  fireside  at  night 
read  these  in  lieu  of  trashy  novels  or  yellow,  secular 
journals.  Read  and  study  your  medical  books,  for 
the  training  that  you  received  at  the  medical 


IO6  HOW  TO  SUCCEED  IN 

college    just    fits    you    for    actual    study    at    the 
bedside. 

You  have  worked  hard  for  several  years  in 
acquiring  knowledge ;  take  an  opportunity  to  impart 
it  to  others.  You  may  have  seen  what  you  took 
to  be  a  unique  case  during  your  first  month  in  prac- 
tice; write  it  down  and  send  it  to  the  editor  of  some 
first-class  medical  journal;  he  will  be  glad  to  receive 
and  publish  it.  Sydenham  said :  "I  have  always 
thought  (and  not  without  reason)  that  to  have  pub- 
lished for  the  benefit  of  afflicted  mortals  any  certain 
method  of  subduing  even  the  slightest  disease,  was 
a  matter  of  greater  felicity  than  the  riches  of  a 
Tantalus  or  a  Croesus.  I  have  called  it  a  matter 
of  greater  felicity;  I  now  call  it  a  matter  of  greater 
goodness  and  of  greater  wisdom."  Let  me  warn 
you,  however,  against  writing  too  much.  Many  men 
have  this  fault,  which,  instead  of  advancing  their 
reputations,  tends  to  lessen  them  in  the  estimation 
of  doctors.  Beware,  too,  of  believing  all  things  that 
are  said  through  these  channels.  To  write  is  one 
thing,  to  tell  the  truth  is  another,  and  the  man  who 
writes  so  very  often  and  narrates  so  many  things 
is  apt  to  ' '  let  slip  "  a  few  that  are  not  entirely  cor- 
rect. Perhaps  it  is  an  accident,  but  it  is  well  to 
' '  keep  an  eye  "  on  all  such.  I  have  known  a  few 
men  in  my  time  whose  epitaph  should  be,  ' '  He 


THE  PRACTICE  OF  MEDICINE  IO/ 

wrote  himself  to  death."  As  time  goes  on  and  you 
grow  rich  —  in  experience — write  again  and  again. 
This  subserves  several  purposes:  It  will  keep  your 
mind  trained  to  thought,  and  it  will  give  you  some 
reputation  in  the  profession.  No  man  should  ' '  hide 
his  light  under  a  bushel,"  but  if  you  have  a  good 
thing  let  it  be  known.  At  the  end  of  the  year  have 
the  copies  of  these  journals  bound,  and  they  will 
make  a  nice  contribution  to  your  library. 

A  LIBRARY. 

You  will  need,  above  all  things,  a  library ;  without 
one  you  would  be  as  the  machinist  without  tools. 
It  is  painful  to  go  into  a  doctor's  house  or  office 
and  see  that  his  ' '  library  "  consists  of  half  a  dozen 
antiquated  volumes;  and  it  is  safe  to  say  they  are 
never  read.  Nor  should  it  be  sufficient  for  you  to 
own  a  medical  library  only.  I  heard  a  doctor  say 
once  that  he  only  knew  medicine,  nothing  more. 
What  folly!  The  doctor  should  be  the  best-posted 
man  in  the  county.  He  should  never  lose  sight  of 
the  fact  that  he  is  a  citizen,  and  being  such,  he  owes 
it  to  his  town,  county,  and  State  to  be  posted  on 
current  affairs.  You  should  know  something  about 
law,  religion,  and  politics.  The  man  who  boasts 
that  he  does  not  know  anything  about  the  merits 
or  demerits  of  any  political  party  or  candidate  is 


IO8  HOW  TO  SUCCEED 

not  a  good  citizen  and  deserves  to  be  censured 
rather  than  applauded.  An  American  should  be 
proud  enough  of  his  country  to  know  in  what  man- 
ner its  achievements  outshine  other  nations,  and  it 
is  no  compliment  to  say  of  him  that  he  doesn't  care. 
If  the  world  ever  seems  lackadaisical,  read  works  of 
fiction;  commune  with  Sir  Walter  Scott,  Dickens, 
or  Hume;  or  with  Shakespeare,  Byron,  or  Bacon. 
There  will  come  times  that  you  should  commune 
with  lighter  spirits,  such  as  Eugene  Field  or 
James  Whitcomb  Riley,  for  they  will  sing  to  you 
of  the  old  home  or  the  prattling  of  children.  It 
will  do  you  good  sometimes  to  read  light  fiction  — 
laugh  with  those  who  laugh — for  your  daily  occu- 
pation is  to  ' '  weep  with  those  that  weep. "  Acquire 
first  one  volume,  then  another  —  just  as  your  means 
will  permit  —  and  before  you  know  it  you  will  have 
a  very  presentable  library.  Intersperse  history  with 
fiction,  law  with  medicine,  poetry  with  geography, 
fun  with  tales  of  woe,  and  hilarity  with  melancholy; 
for  at  last  is  this  not  the  way  of  real  life  and  the 
song  of  the  world  since  its  foundation  ?  Tears  and 
laughter,  joy  and  sadness,  glad  fruition,  then  death. 
Read,  think,  digest,  for  the  hours  are  few  and  the 
days  short  in  which  to  work.  Resolve  that  while 
life  lasts  you  will  be  no  laggard,  but  an  earnest 
worker. 


CHAPTER  VII 

THE  BUSINESS  SIDE  OF  IT 

Be  it  said  to  their  credit,  or  discredit,  it  never 
seems  to  occur  to  doctors  that  there  is  a  business 
side  to  their  profession.  The  mention  of  the  fact 
that  there  is  may  make  some  people  hold  up  their 
hands  in  horror.  Good  enough,  for  it  is  principally 
to  this  very  class  that  I  will  address  my  remarks. 

I  knew  a  member  of  the  medical  profession  (a 
most  honorable  and  competent  physician  he  was) 
that  practiced  for  over  sixty  years  in  one  locality 
in  an  interior  town  of  Kentucky.  Think  of  the 
service  that  this  man  rendered  to  these  people  dur- 
ing that  long  period  of  time!  He  officiated  at  the 
ushering  into  the  world  of  hundreds,  if  not  thou- 
sands, of  them ;  he  saw  them  grow  to  man's  estate 
and  soothed  the  pangs  as  many  of  them  passed 
through  the  throes  of  death.  Many  lived  to  see 
him  pass  out  into  the  ' '  darkness. "  Think  of  the 
tales  of  woe  that  he  could  recite,  the  heart  throbs 
that  were  strokes  of  grief,  sorrow,  and  tribulation. 
Think  of  the  hardships  encountered  in  those  early 
days  of  practice,  devoid  of  any  of  the  comforts  that 
come  to  the  "modern"  doctor;  think  of  the  count- 
less number  that  were  unable  to  render  him  recom- 


IIO  HOW  TO  SUCCEED  IN 

pense  save  by  words  of  gratitude  or  tears  of  love 
and  affection;  think  of  the  multitude  of  others  who 
gained  his  confidence,  besought  his  services,  and 
received  his  best  attention,  and  who  refused  or  for- 
got to  reward  him,  even  with  a  word  of  thanks;  for 
this  old  man  died,  after  threescore  and  ten,  too 
poor  to  leave  his  family  a  comfortable  living  and 
with  scarce  enough  to  provide  a  decent  burial. 
And,  too,  it  was  told  me  that  although  accounts 
amounting  to  many  thousands  of  dollars  were  on 
his  books  uncollected,  now  that  he  is  dead  they  are 
not  worth  the  paper  on  which  they  are  written. 
And  yet  you  say  that  there  should  be  no  business 
side  to  the  practice  of  medicine? 

I  knew  another  most  worthy  member  of  the  medi- 
cal profession,  living  in  one  of  the  large  cities,  who 
while  living  provided  for  his  family  in  a  most  luxu- 
rious, if  not  extravagant,  way.  After  his  death  it 
was  found  that  not  a  penny  was  left,  and  from  that 
day  they  have  been  in  poverty  and  forced  to  make 
a  living  for  themselves  —  wife  and  daughter — by 
menial  work.  And  you  say  that  we  should  not 
speak  of  a  business  side  to  the  medical  profession? 

It  has  become  proverbial  that  doctors  do  not 
know  a  thing  about  "business."  I  have  heard 
more  than  one  doctor  seemingly  boast  that  he  pos- 
sessed no  such  knowledge,  and  it  is  an  every-day 


THE  PRACTICE  OF  MEDICINE  III 

occurrence  to  hear  them  say  that  they  are  "poor 
collectors."  It  is  a  shame  that  these  things  are 
true,  and  the  day  will  come  to  each  and  all  of  them 
when  they  will  repent  both  the  saying  and  the  con- 
dition. You  have  the  right  as  an  individual  to 
pursue  this  course  if  you  please,  but  you  have  no 
right  to  bring  poverty  and  privation  upon  your 
family,  which  is  sure  to  come  to  them  at  your  death. 
Again:  The  physician  who  willingly  allows  his 
clientele  to  dictate  terms  to  him,  or  is  willing  to 
make  reductions  to  suit  and  please  his  patients,  is 
doing  his  profession  an  irreparable  injury,  and  he 
should  be  ashamed  to  do  so.  It  is  undignified 
and  brings  the  profession  into  disrepute,  besides 
being  unjust.  If  your  services  are  not  worth  what 
you  have  charged  for  them,  say  so  and  take  less, 
but  do  not  underrate  your  services  by  reductions 
which  are  ridiculous  from  a  business  standpoint. 
What  would  you  think  of  a  grocer  or  tradesman  of 
any  sort  who,  when  you  went  to  settle  his  account, 
would  reduce  it  one  third?  The  natural  presump- 
tion would  be  that  his  goods  were  not  worth  the 
price  he  had  asked  for  them.  So  it  is,  and  the 
same  should  be  thought  of  the  doctor  who  is  will- 
ing to  take  two  thirds  for  the  whole  amount 
charged — that  his  services  were  not  worth  the 
amount  charged  for  them. 


112  HOW  TO  SUCCEED  IN 

I  heard  once  of  a  lady  going  to  her  doctor,  who 
had  attended  her  through  a  long  attack  of  fever,  to 
ask  for  and  settle  her  bill  for  his  services.  The 
following  conversation  took  place: 

Lady:  "Doctor,  I  have  called  to  settle  my  bill; 
what  is  the  amount?" 

Doctor  (looking  over  his  books):  "I  paid  you 
seventy  visits  at  two  dollars  per  visit;  this  would 
make  the  amount  one  hundred  and  forty  dollars." 

Lady:   "But,  doctor" 

Doctor:  "Well,  you  being  an  old  patient  and 
good  friend,  I  will  put  the  amount  at  one  hundred 
dollars." 

Lady:   "But,  doctor,  you  must  remember" 

Doctor:  "Oh,  well,  call  it  seventy-five  dollars 
and  square." 

Lady:  "I  must  insist,  doctor,  on  saying  that  the 
first  charge  of  one  hundred  and  forty  dollars  was 
much  too  small." 

Doctor:   "Oh!" 

But  the  most  despicable  character  is  the  man 
who  starts  in  to  undercharge  his  competitors  in 
order  to  advance  his  number  of  patients.  If  you 
are  going  to  be  a  "  cheap  "  doctor  all  right,  but  to 
use  your  brother  practitioner's  rate  to  enhance 
yourself  by  "cutting  under"  you  descend  to  the 
level  of  the  mountebank.  A  physician  was  once 


THE  PRACTICE  OF  MEDICINE  113 

asked  why  it  was  that  he  charged  three  dollars  a 
visit  and  Dr.  Blank  only  charged  two.  In  answer, 
the  doctor  said:  "I  know  what  my  services  are 
worth,  and  I  suppose  that  Dr.  Blank  knows  what 
his  are  worth."  There  are  many  methods  em- 
ployed by  designing  ones  in  order  to  get  the  servi- 
ces of  a  doctor  free.  For  instance,  resort  is  had 
to  the  ' '  curbstone  conference  "  in  lieu  of  going  to 
the  office  or  residence.  After  questioning,  and  a 
recital  of  symptoms,  a  prescription  is  given,  but 
if  the  doctor  dare  charge  for  it  he  is  accounted 
unjust  and  extortionate.  I  never  could  see  any 
difference  between  prescribing  for  one  on  the  street 
or  in  the  office,  and  your  habitual  practice  should 
be  to  charge  for  such  prescriptions.  I  saw  a  ruse 
once  practiced  on  a  doctor  for  the  purpose  of 
avoiding  of  the  payment  of  fifty  cents,  to  which 
the  doctor  fell  an  easy  victim.  A  man  of  means, 
but  very  penurious,  walked  into  his  office  (in  the 
country)  and  requested  that  the  doctor  extract  a 
tooth  for  him.  The  patient  asked  if  it  would  hurt 
much.  The  doctor  replied  that  if  it  did  not  hurt 
that  he  would  not  charge  a  cent.  After  much 
pulling  on  the  part  of  the  doctor  and  squirming  on 
the  part  of  the  patient  the  tooth  came  out.  ' « Did 
it  hurt?"  asked  the  doctor.  "No,  not  a  bit," 
responded  the  patient,  as  he  walked  away  without 


1 14  HOW  TO  SUCCEED  IN 

paying  anything.  The  doctor  only  wished  for  a 
second  opportunity.  Beware  of  the  telephone, 
that  great  invention  of  modern  times.  At  noon- 
time when  you  are  at  dinner,  at  midnight  when 
you  are  fast  asleep,  it  will  ring,  ring,  ring.  You  go 
to  it,  or  have  your  wife  go,  when  something  like 
this  will  be  said:  "Doctor,  little  Julia  is  doubled  up 
with  the  cramps.  What  must  I  do  for  her?"  You 
wish  that  little  Julia  would  go  to  the  eternal  pow- 
wows, but  in  your  blandest  way  tell  her  the  nec- 
essary thing  to  do — and  forget  to  charge  for  it.  I 
knew  a  doctor  once  that  had  an  office  fronting 
directly  on  a  prominent  street.  A  certain  gentle- 
man made  it  convenient  to  stop  at  the  window  on 
his  way  to  business  and  get  advice  and  an  occa- 
sional prescription.  After  the  elapse  of  a  year  the 
doctor  sent  him  a  bill  amounting  to  a  good  round 
sum.  He  testified  in  court  that  this  doctor  had 
never  been  in  his  house  and  had  never  attended 
him  in  sickness,  and  claimed  that  he  did  not  owe 
him  anything.  The  "Court"  did  not  see  it  in 
that  light,  and  he  was  compelled  to  pay  the  amount 
charged.  Happy  lesson — you  should  profit  by  it. 
I  had  the  pleasure  in  my  early  professional  life  of 
being  associated  with  a  physician  who  was  a  thor- 
ough business  man  and  a  good  ' '  collector. "  This 
fact  was  known  by  the  people  at  large,  and  the  mere 


THE  PRACTICE  OF  MEDICINE  115 

fact  that  it  was  aided  him  materially,  for  whenever 
a  family  employed  him  they  were  cognizant  of  the 
fact  that  they  would  be  expected  to  pay  him  if  they 
were  able  to  pay.  He  not  only  did  a  large  and 
lucrative  practice,  but  he  left  his  family  independent 
of  the  world's  care  after  he  died. 

When  a  young  man  adopts  the  medical  profes- 
sion for  his  life's  work  I  am  sure  he  does  it  after  the 
following  reflections:  First,  it  is  an  honorable  and 
high  calling.  This  is  very  true,  for  medicine  ranks 
with  the  law  and  the  ministry — the  three  great 
and  honored  professions.  Without  discountenanc- 
ing or  underestimating  either  of  the  other  two,  I 
am  fully  persuaded  that  it  should  rank  first  of  the 
three.  The  law  deals  with  property  rights,  medi- 
cine with  the  health  of  the  individual;  the  law  with 
decrees  of  divorce,  medicine  ameliorates  pain  of 
body  and  distress  of  mind,  and  to  a  degree  makes 
us  willing  to  "bear  the  ills  we  have";  law  seeks  to 
clear  the  criminal,  or  is  made  the  instrument  for  so 
doing,  medicine  determines  the  rational  or  irra- 
tional state  of  the  mind,  and  by  so  doing  saves  the 
innocent  and  is  the  means  of  having  the  guilty 
punished ;  law  confines  the  unfortunate  in  the  mad- 
house, medicine  "ministers  to  a  mind  diseased" 
and  relieves  him.  With  the  minister  the  doctor 
goes  hand  in  hand.  The  doctor  relieves  the  pain 


Il6  HOW  TO  SUCCEED  IN 

that  racks  the  body,  the  minister  the  thoughts  that 
distress  the  soul.  The  doctor  soothes  the  afflicted, 
binds  up  broken  limbs  and  broken  hearts,  lends  a 
hand  to  the  distressed,  and  comforts  those  that 
mourn;  quiets  the  suckling  babe,  and  is  leaned  on 
when  youth  is  gone  and  age  has  crippled,  consoles 
the  disconsolate  mother,  administers  to  the  broken- 
hearted father,  shares  the  sorrows  of  the  poor  and 
the  afflictions  of  the  sick.  Can  the  minister  do 
more  than  this?  I  knew  a  country  doctor  whose 
common  habit  it  was  to  carry  packages  of  food 
and  raiment  to  his  indigent  patrons  and  to  furnish 
medicine  free  for  all  their  aches  and  pains.  I  was 
in  his  office  upon  two  occasions,  a  year  apart,  and 
I  saw  him  secretly  give  at  one  time  one  dollar,  at 
another  two  dollars,  to  the  poor  patients  with  which 
to  buy  medicine — and  the  charge — well!  He  is 
dead  now,  and  it  is  needless  to  say  died  poor.  No 
monument  marks  his  resting  place,  but  in  that 
country  beyond  the  stars  he  must  have  received 
the  plaudit,  ' '  Well  done. " 

Second,  is  it  remunerative  and  will  it  afford  me 
ample  means  to  support  myself  and  family? 
Since  you  had  this  thought  in  mind,  I  venture 
that  if  you  had  thought  to  the  contrary  you 
never  would  have  adopted  the  calling.  You 
would  have  been  foolish  not  to  have  given  this  con- 


THE  PRACTICE  OF  MEDICINE 

sideration  to  a  business  that  you  were  to  follow 
for  life.  No  minister  of  the  blessed  gospel  but  gives 
this  consideration  to  his  calling,  for  it  is  right  and 
proper  that  he  should  do  so.  It  is  writ  that  a 
man's  first  duty  is  to  his  family,  and  surely  part  of 
this  duty  is  to  support  them,  and  in  this  age  and 
generation  one  can  not  live  alone  on  air.  There 
would  be  but  one  alternative  left  if  he  did  not 
demand  and  receive  pay  for  his  services,  and  that 
would  be  that  he  would  ' '  sponge  "  and  live  off  of 
his  neighbors.  Well,  a  long  time  ago  this  might 
have  done,  but  in  ' '  these "  days  it  won't  work. 
Any  way,  I  always  had  a  contempt  for  any  able- 
bodied  man,  be  he  minister,  doctor,  or  what  not, 
that  would  ' '  sponge  "  off  his  neighbors.  Yes,  the 
medical  profession  will  prove  remunerative  enough 
to  support  your  family  if  you  will  demand  pay  for 
your  services  and  see  that  you  get  it.  If  you  do 
not  do  this  you  are  neither  man  or  Christian;  there- 
fore start  out  with  the  presumption  that  your 
services  are  worth  what  you  ask  for  them,  and  be  a 
good  collector.  In  making  this  assessment  remem- 
ber that  a  doctor's  family  should  move  in  good 
society  "and  wear  good  clothes."  You  should 
consider  that  the  wife  is  to  be  "first  lady"  at  the 
same  time  that  you  are  playing  the  ' '  role  "  of  first 
citizen  of  the  county.  I  use  the  term  "first" 


Il8  HOW  TO  SUCCEED  IN 

advisedly,  for  I  would  have  you  start  in  your  pro- 
fession with  no  other  idea  than  to  \ytfirst  in  every- 
thing you  undertake.  Down  here  in  Kentucky 
' '  the  horse  that  ran  second "  receives  but  little 
applause,  but  the  one  that  comes  to  the  "string" 
first  not  only  gets  all  the  applause,  but  ' '  bags " 
the  money.  Very  much  the  same  is  it  in  medicine, 
or  in  any  other  calling.  Suppose  you  were  making 
a  race  for  Congress,  which  I  trust  you  never  will, 
and  you  ' '  come  in  one "  of  being  elected ;  of  what 
account  is  that?  The  other  fellow  was  first. 
Your  family  must  then  be  able  to  dress  well,  and 
the  "partner"  deserves  all  the  extras  that  you 
can  give  her.  Expenses  will  be  a  little  high,  but 
you  must  work  the  harder  and  be  able  to  meet 
them.  You  will  find  that  the  "little  woman"  will 
always  be  willing  to  ' '  cut  low "  when  it  is  neces- 
sary. Yes,  you  will  find  that  your  profession  will 
be  remunerative  enough  for  you  to  live  like  a  gen- 
tleman. If  it  proves  not  to  be  it  is  your  own 
fault,  and  you  should  quit  it  at  once  and  go  to 
swapping  horses  or  engineering  a  motor  car,  or 
something  more  to  your  taste  and  ability. 

Third,  that  it  will  afford  you  an  opportunity  to 
gratify  your  ambition.  I  like  a  man  to  talk  like 
that,  for  the  man  who  has  no  ambition  is  of  as 
little  use  in  this  world  as  the  fifth  wheel  to  a 


THE  PRACTICE  OF  MEDICINE 

wagon.  You  are  starting  out  then  to  succeed,  and 
if  you  keep  up  the  determination  you  are  just  as 
sure  to  do  it  as  the  sparks  are  to  fly  upward 
or  taxes  be  collected.  Succeed  at  what?  In 
making  a  living,  in  relieving  the  sick,  and  gaining 
a  high  position  in  your  profession.  This  certainly 
should  gratify  your  ambition. 

A  man  who  was  once  a  ' '  common  country  "  doc- 
tor, and  that  too  in  one  of  the  poorest  counties  in 
Kentucky,  succeeded  to  that  degree  that  he  became 
the  Chief  Justice  of  the  United  States,  supreme 
bench,  and  when  Judge  Miller  died  it  was  said  that 
the  greatest  legal  light  in  the  Union  went  out. 
Men  who  have  been  ' '  hewers  of  wood  and  drawers 
of  water  "  have  attained  to  the  highest  positions  in 
the  medical  profession.  With  application,  energy, 
and  perseverance  you  will  eventually  reach  to  the 
full  fruition  of  your  ambition. 

Having  now  begun  work,  you  should  occasionally 
stop  to  think.  I  imagine  that  this  thought  will 
sometimes  come  to  you:  "  It  is  true  that  I  am  now 
making  a  very  respectable  living  for  my  family,  but 
suppose  that  I  should  suddenly  be  '  cut  off, '  I  have 
nothing  to  leave  my  family."  This  indeed  is  a 
very  serious  proposition,  and  how  are  you  to  meet 
it?  Let  me  suggest  one  way:  Take  out  a  life  policy 
in  some  good,  substantial  company ;  it  might  be  best 


I2O  HOW  TO  SUCCEED  IN 

on  the  endowment  plan.  Count  up  your  earnings 
for  the  past  year  and  see  what  amount  you  would 
be  justified  in  taking  out.  Of  course  you  do  not 
want  to  be  embarrassed  by  the  payments,  so  con- 
sider this  carefully.  We  will  suppose  that  your 
collections  during  the  past  year  summed  up  a  total 
of  one  thousand  dollars.  This  would,  I  think, 
enable  you  to  take  out  a  policy  of  fifteen  hundred 
dollars  on  the  twenty-year  endowment  plan.  We 
will  suppose  your  age  to  be  twenty-five  years;  the 
annual  payment  would  be  seventy-five  dollars. 
At  the  end  of  twenty  years,  or  at  forty-five  years 
of  age,  you  would  be  paid  cash  in  hand  the  sum 
of  two  thousand  dollars,  and  should  you  die  in  the 
interim  your  family  would  be  paid  the  full  value  of 
the  policy  with  accrued  dividends.  Quite  a  nice 
little  amount  to  be  handed  you,  and  you  have 
scarcely  missed  the  sum  you  paid  to  ' '  keep  it  up. " 
As  the  years  go  by  you  will  increase  the  amount 
of  your  policy;  then  come  what  will  you  will  sleep 
in  peace,  at  least  as  far  as  the  care  of  your  loved 
ones  is  concerned  after  your  death. 

Again:  You  are  to  "think  out"  plans  which  will 
enable  you  to  succeed  in  a  business  way  in  order 
to  provide  for  the  family  while  you  live,  now  that 
they  are  cared  for  if  you  die.  Let's  begin  right,  for 
it  would  be  a  most  difficult  thing  to  change  any 


THE  PRACTICE  OF  MEDICINE  121 

plan  of  procedure  with  which  you  had  begun.  Do 
you  understand  bookkeeping?  If  so,  all  right;  if 
not,  a  few  lessons  will  explain  the  simple  process 
which  is  to  aid  you  in  your  purpose;  but  I  beg  of 
you  don't  be  lax  about  it,  even  if  it  is  simple.  A 
charge  should  be  made  for  every  service  that  is 
rendered,  and  credit  given  for  every  cent  collected. 
In  this  matter  do  not  put  off  till  to-morrow  what 
should  be  done  to-day.  You  might  forget  some- 
time, and  you  know  that  "every  cent  counts," 
especially  to  a  poor  young  doctor.  If  it  were  not 
for  the  fear  of  imposing  upon  the  ' '  silent  partner  " 
I  would  suggest  that  you  hand  your  day-book  over 
to  her  and  let  her  take  care  of  the  ' '  ledger. "  Now 
that  your  accounts  are  charged  or  ' '  entered, "  you 
should  turn  your  attention  to  their  collection,  for 
of  what  use  are  they  ' '  on  the  books "  ? 

Let  me  again  suggest:  If  you  are  located  in 
the  country,  I  would  advise  that  you  "let  it  be 
known"  that  you  expect  the  settlements  of  your 
accounts  twice  a  year,  at  least  on  the  first  day  of 
January  and  on  the  first  day  of  July.  Of  course, 
you  have  talked  this  to  your  patrons,  but  to  impress 
the  matter,  during  the  last  days  of  December  and 
the  last  days  of  June  send  out  a  statement  through 
the  mails  of  all  accounts.  But  you  may  say, 
'  4  That  would  not  do,  for  no  doctor  in  the  country 


122  HOW  TO  SUCCEED  IN 

does  that. "  True,  and  perhaps  no  other  doctor  in 
the  country  uses  antidiphtheritic  serum.  Are  you 
going  to  refuse  to  use  it  on  this  account?  Let  it 
be  an  innovation  then;  send  out  your  statements. 
It  may  be  that  you  think  it  will  offend  your  patrons 
and  that  you  will  lose  their  patronage.  Tut!  tut! 
Any  man  who  does  not  put  the  value  of  your  ser- 
vices above  the  fact  that  you  send  him  a  state- 
ment, let  him  go  —  to  the  other  doctor,  and  I  would 
be  willing  to  wager  that  at  the  end  of  the  year  you 
will  "thank  your  stois"  that  you  are  rid  of  him. 

If  you  live  in  the  city,  I  would  advise  that  instead 
of  sending  the  statement  twice  a  year,  you  send 
them  on  the  first  day  of  each  month.  Here  you  will 
have  easier  sailing,  as  many  physicians  do  the  same. 
Even  if  they  do  not,  this  is  a  free  country,  and  you 
have  the  right  to  do  as  you  please  just  so  long  as 
you  do  not  violate  the  law.  This  disposition  of 
doctors  to  fear  that  they  will  do  something  which 
will  militate  against  their  prospects  is  the  very 
thing  that  has  brought  the  profession  into  ridicule 
in  a  business  light,  and  financially  ruined  many  a 
good  man. 

We  will  suppose  that  the  year  has  come  and 
gone,  and  January  has  passed  the  second  time,  but 
your  « '  statement "  has  gone  unheeded.  The  wheat 
has  been  threshed,  garnered,  and  sold;  the  tobacco 


THE  PRACTICE  OF  MEDICINE  123 

cut,  dried,  and  carried  to  market;  the  corn  shocked 
and  fed  to  the  swine,  and  the  swine  sold  at  good 
profit;  even  the  fattest  calf  has  been  made  into 
steak,  and  the  mutton  palmed  off  as  lamb.  Yet 
not  a  word  has  been  heard  in  response  to  your 
"statement."  What  are  you  to  do?  Why,  speak 
to  the  man  about  it,  of  course.  But  again,  you 
are  ashamed  to  do  this.  Ashamed  to  ask  for  that 
which  rightfully  belongs  to  you,  both  under  the  law 
of  God  and  man !  Is  it  possible  that  you  think  that 
your  account  is  an  unjust  one,  that  you  have 
charged  too  much,  or  that  your  services  did  not 
amount  to  anything?  If  so,  you  should  not  have 
sent  the  "statement."  But  being  an  honest  one, 
and  not  extortionate,  you  should  now  insist  upon  its 
payment.  By  kind,  persuasive  measures  at  first, 
and  if  these  do  not  prevail,  then  do  as  all  business 
men  would  do,  put  it  in  the  hands  of  the  law  for 
collection.  But,  you  may  say,  this  will  offend  the 
man.  Well  and  good,  let  him  be  offended,  but 
you  will  get  your  money.  Of  what  use  is  he  to  you 
as  a  patron  if  he  never  pays  you  for  your  services? 
You  should  be  glad  to  get  rid  of  him,  for  you  will 
save  many  hard  rides  and  restless  moments;  be- 
sides, you  were  never  more  mistaken  in  your  life, 
for  after  he  has  paid  you  "by  the  law"  he  will 
become  your  staunch  friend  and  supporter,  and 


124  HOW  TO  SUCCEED  IN 

pay  you  the  "next"  time.  If  you  do  not  care 
enough  for  your  own  welfare  to  conduct  your  busi- 
ness along  these  business  channels,  you  should  do 
so  as  a  precedent  for  those  who  are  to  follow  you. 
We  plant  trees  for  the  benefit  of  future  genera- 
tions, so  should  we  protect  them  in  other  ways. 

Having  now  prospered  by  the  pursuit  of  your 
profession  in  a  business  way,  you  notice  at  the  end 
of  each  year  a  surplus.  What  are  you  to  do  with 
it?  Don't  squander  it  or  spend  it  in  riotous  living 
and  ways  of  extravagance.  You  have  been  frugal 
in  obtaining  it;  do  not  grow  reckless  and  spend  it 
"in  a  night."  Beware  of  the  peddler,  the  shyster, 
and  the  lightning-rod  man,  for  the  buying  of  gew- 
gaws has  bankrupted  many.  Don't  imitate  Mrs. 
Smith,  who  bought  a  door-plate  with  the  name  of 
Jones  on  it,  arguing  that  ' '  It  may  be,  after  Mr. 
Smith  dies,  that  I  will  marry  a  man  by  the  name 
of  Jones. "  Beware  also  of  the  man  who  under  the 
guise  of  friendship  beguiles  you  by  telling  of  an 
investment  that  is  sure  to  profit  you  a  hundred  per 
cent,  but  more  likely  a  thousand.  A  gold  or  silver 
mine,  an  oil  well,  or  cheap  lands  that  are  filled 
with  minerals,  yea  to  overflowing;  a  patent  that  is 
to  revolutionize  the  world  and  bring  you  millions. 
Remember  the  fate  of  Colonel  Sellers  with  his 
celebrated  eye-water.  Listen  attentively  to  these 


THE  PRACTICE  OF  MEDICINE  12$ 

gentlemen,  not  too  long,  and  if  persistent  throw 
them  out  of  the  back  window,  and  if  you  break 
their  necks  you  will  be  doing  the  public  a  great 
service,  and  will  throw  around  your  family  a  man- 
tle of  protection. 

Be  content  to  "move  along  the  lines  of  least 
resistance,"  and  make  money  in  an  honest,  legiti- 
mate way.  It  may  be  slow  but  it  will  be  sure, 
and  an  honest  penny  is  more  to  be  desired  than  a 
whole  lapful  of  riches  acquired  in  a  dishonest  way. 
Schemers  and  "slick  citizens"  usually  meet  with 
their  just  reward,  and  the  designing  rascal  is  sure 
to  come  to  grief.  What  are  you  to  do  with  your 
surplus?  Put  it  in  some  tangible  investment,  for 
speculations  will,  like  birds,  "take  wings  and  fly 
away "  with  your  money.  Buy  a  piece  of  land  if 
you  live  in  the  country,  a  town  lot  or  a  cottage  if 
you  live  in  the  city.  Before  you  know  it  you  will 
own  a  farm,  or  a  house  of  some  real  proportions. 
Every  doctor  should  have  ' '  in  his  mind's  eye  "  the 
accumulation  of  funds  sufficient  to  take  care  of  him 
and  his  family  in  the  event  of  sickness  and  sup- 
port him  in  old  age,  or  perchance  should  he  desire 
to  retire,  that  amount  which  would  enable  him  to 
do  so.  Do  not  be  penurious,  only  discreet.  A 
penurious  person  is  one  much  to  be  despised,  for 
he  would  oppress  the  poor  and  bring  the  orphan  to 


126  HOW  TO  SUCCEED  IN 

grief.     However  much  people  may  revile  you,  re- 
member that  ' '  charity  begins  at  home. " 

It  may  be  pleasant  now  to  retrospect  and  see 
how  well  these  ' '  business  methods  "  have  prospered 
you  during  these  past  five  years.  The  first  year 
you  netted  six  hundred  dollars  only,  but  you  must 
not  forget  the  cow  you  got  from  Smith  or  the  hogs 
from  Jones  "on  account, "  for  has  not  "Brindle" 
supplied  enough  milk  to  use  for  the  family? — and 
don't  forget  that  enough  butter  was  made,  and  to 
"spare";  and  the  hogs,  why  they  supplied  the 
winter's  meat.  The  garden  supplied  all  vegetables, 
and  you  find  a  few  dollars  left — only  a  few — out 
of  the  year's  work.  Did  your  neighbor  do  any 
better?  The  farmer  "growls"  because  the  rain- 
fall during  the  year  failed  to  come  within  an  inch 
of  what  it  did  last  year,  and  says  he  has  only  a  half 
crop  of  corn,  though  he  really  acknowledges  that 
the  crop  of  wheat,  hay,  oats,  and  potatoes  was 
good.  He  forgets  to  add  that  corn  has  gone  up  a 
number  of  ' '  points  "  because  of  that  ' '  lack  "  of  rain, 
and  that  he  is  the  gainer  thereby.  Did  you  ever 
know  a  farmer  that  did  not  « '  growl "  ?  If  the 
weather  is  clear  he  is  sure  that  it  will  never  rain, 
and  if  it  rains  he  is  sure  that  it  will  never  stop. 
With  him  there  never  was  the  least  prospect  of  a 
"peach "crop,  and  he  was  never  convinced  until 


THE  PRACTICE  OF  MEDICINE  I2/ 

the  peaches  were  so  plentiful — each  year — that 
they  "were  not  worth  a  cent  in  market."  The 
frost  is  always  "a  killing  frost"  with  him,  but 
' '  somehow  or  other  "  he  has  managed  to  live.  The 
grocer  across  the  way  reports  a  very  good  year  and 
estimates  his  "savings"  at  eight  hundred  dollars. 
But  you  must  remember  that  his  stock  represents 
an  investment  of  five  thousand  dollars  or  more, 
and  your  ' '  stock  in  trade  "is  "  brains, "  not  cash. 
The  haberdasher  has  not  done  much,  reporting 
only  three  hundred  dollars  profit,  but  as  he  is  a 
1 '  single "  man  he  can  live  on  that.  The  black- 
smith says  that  he  does  not  know  what  his  earn- 
ings were,  but  that  he  is  contented  and  happy. 
And  why  should  he  not  be?  A  little  home  paid 
for,  a  wife  that  is  a  helpmeet  indeed,  and  children 
that  ' '  round  up  "  at  an  even  dozen.  Then,  too, 
they  have  all  been  well  during  the  year  and  have 
plenty  to  eat.  ' '  Go  to  the  ant,  thou  sluggard " 
should  be  paraphrased  to  read  ' '  Go  to  the  black- 
smith, thou  rich  man  and  woman";  learn  from  him 
and  his  many  lessons — contentment,  happiness, 
and  no  infringement  on  nature's  laws.  Twelve 
bright-faced,  healthy  children  bespeak  the  fact. 
Look  at  the  man — broad-shouldered,  tall,  with 
muscle  as  hard  as  iron  and  nerve  unshaken.  With 
the  eye  as  an  X-ray  we  see  a  heart  pumping  pure, 


128  HOW  TO  SUCCEED  IN 

untainted  blood,  full  of  red  corpuscles.  Go  to,  you 
pale,  puny,  and  ill-shaped  being,  you  shut  out  the 
fresh,  pure  air  and  bright  sunlight  that  God  has 
given  you  and  substitute  for  it  in  your  palaces  the 
foul  air  of  furnaces  and  the  gleam  of  artificial  light. 
No  wonder  that  your  health  gave  way,  your  nerves 
are  unstrung,  and  your  stomach  refuses  to  receive 
the  pure  food  of  the  fields  and  forests.  Yes,  be 
content,  good  blacksmith  ;  though  your  trade  is 
black  your  heart  is  white,  and  you  not  only  repre- 
sent the  "bone  and  sinew"  of  the  land  but  the 
brain  and  brawn  as  well.  From  your  ranks  come 
presidents  and  other  men  who  are  called  great,  and 
your  calling  is  no  disgrace.  Go  on  playing  your 
' '  anvil  chorus "  and  serving  God,  and  you  will  at 
that  last  day  join  ' '  the  great  chorus  "  of  good  men 
made  perfect,  who  sing  "Hosanna  to  the  King." 

So  you  see  that  you  have  done  very  well  for  the 
first  year.  Six  hundred  dollars — six  per  cent  on 
ten  thousand  dollars — that's  not  bad,  is  it?  Count- 
ing up  the  net  income  for  the  fifth  year,  you  find 
the  sum  of  three  thousand  dollars,  not  to  speak  of 
the  wheat,  corn,  and  eggs  that  have  been  contrib- 
uted by  the  poor.  And  you  have  added  a  number 
of  acres  to  the  farm  and  increased  your  life  policy 
until  it  now  reads  twenty-five  hundred  dollars 
instead  of  fifteen  hundred  dollars.  Compare  your 


THE  PRACTICE  OF  MEDICINE  129 

condition  with  that  of  the  other  doctor,  who  has 
jogged  on  in  the  old  way  and  ' '  made  light "  of 
your  business  methods.  He  will  be  borrowing 
money  from  you  in  less  than  a  year,  if  he  has  not 
already  done  so.  Six  per  cent  on  fifty  thousand 
dollars  —  well,  that's  not  bad,  and  you,  like  the 
' '  smith, "  should  be  content. 


CHAPTER  VIII 

THE  YOUNG  VERSUS  THE  OLD  DOCTOR 

It  is  a  pity  to  chronicle  the  fact  that  the  term 
' '  doctor  "  has  but  little  significance  in  this  country. 
In  England,  both  in  London  and  on  the  Continent, 
the  title  of  ' '  doctor  "  is  not  used  by  medical  men. 
I  don't  know  but  that  this  is  a  good  idea;  especially 
would  it  be  so  here,  where  the  title  of  doctor  is 
given  to  any  one,  from  the  man  who  trims  your 
corns,  treats  your  sick  horse  or  cat,  removes  pim- 
ples from  your  face,  draws  your  tooth  or  colors 
your  hair,  to  the  distinguished  gentleman  who  is 
known  as  "the  professor." 

This  reminds  me  of  a  man  who  was  taken  sud- 
denly sick  in  a  distant  part  of  a  thinly  settled 
county,  and  the  neighbors,  including  the  old  wo- 
men, were  called  in  consultation,  no  doctor  living 
in  less  than  twenty  miles  of  the  residence.  He 
was  suffering  from  some  condition  of  obstruction 
of  the  bowels,  and  all  efforts  to  have  them  move 
had  failed.  Even  the  best  known  "yarbs,"  etc., 
had  been  tried,  but  to  no  avail.  The  propriety  of 
sending  for  a  doctor  was  discussed,  but  it  was 
urged  that  the  man  would  die  before  he  could 
reach  the  house.  Some  one  suggested  that  an  old 


THE  PRACTICE  OF  MEDICINE 


horse  doctor  came  every  day  to  a  neighbor's  house 
to  '  '  doctor  "  a  sick  horse,  and  that  it  might  be  well 
to  send  for  him.  This  suggestion  was  accepted, 
and  he  was  sent  for.  Upon  arriving  at  the  patient's 
house  he  asked  a  few  questions,  and  said  :  '  '  Waal, 
I'm  only  a  hoss  doctor;  never  tended  a  human  in 
my  life.  For  a  hoss  in  this  condition  I  would  give 
a  half  pound  of  salts,  but  I  guess  a  quarter  of  a 
pound  would  do  for  a  man."  With  this  he  pro- 
ceeded to  '  '  mix  up  "  this  amount  and  gave  it  to  the 
sick  man,  and  then  took  his  departure.  The  next 
morning  he  started  on  his  way  to  see  his  patient  — 
the  sick  horse  —  and  met  a  man  "chopping" 
wood  near  the  house.  He  thought  that  he 
recognized  in  him  a  person  that  he  had  seen 
at  the  sick  man's  house  the  night  before,  and 
accosted  him: 

'  '  Neighbor,  hev  you  heard  from  the  sick  gentle- 
man over  the  way  this  morning  ?  " 

"Oh  yes,  Doc.,"  said  the  man. 

"Waal,  how  is  he?" 

"He's  all  right,  Doc." 

"Kin  you  tell  me  if  the  medicine  acted  that  I 
give  him  ?  " 

'  <  Oh  yes,  Doc.  ,  it  acted.  " 

'  '  I  am  glad  ter  hear  that,  "  said  the  doctor.  '  '  Kin 
you  tell  me  how  many  times  hit  acted?  " 


1 32  HOW  TO  SUCCEED  IN 

'  *  Well,  Doc. ,  as  well  as  I  can  remember,  it  acted 
well  nigh  onto  twenty  times  before  he  died  and 
nine  times  after  he  died." 

It  is  said  that  the  eminent  horse  doctor  rode 
away  in  an  opposite  direction  without  saying  a  word. 

The  young  doctor  leaves  college  after  a  four  years' 
course  of  hard  study.  He  has  listened  attentively 
to  the  lectures  of  the  professor  on  materia  medica, 
and  is  imbued  with  the  idea  that  every  medicine 
which  has  been  so  thoroughly  described  has  a  spe- 
cific action.  He  tells  its  physical,  therapeutic,  and 
physiological  action,  and  sees  the  result — in  his 
mind's  eye  —  of  each  and  every  one  of  them.  He 
procures  a  beautiful  "case,"  made  of  Russia 
leather,  filled  with  glass  vials  of  the  latest  style 
and  pattern,  with  glass  stoppers  to  fit  each  accu- 
rately, and  well  fitted  to  their  places.  Each  con- 
tains some  drug  with  high-sounding  name  diffi- 
cult of  pronunciation,  but  of  well-known  attributes. 
Their  arrangement  in  the  ' '  case  "  is  perfect,  and 
as  the  lids  are  opened  the  brightness  of  the  forty- 
eight  bottles,  twelve  in  a  row,  excite  admiration 
for  their  glistening  quality.  Stuffed  off  in  one 
corner  are  a  few  old  insignificant  drugs,  such  as 
quinine,  opium,  and  calomel,  with  perhaps  a  small 
package  of  Crab  Orchard  salts.  These  he  is  indif- 
ferent about,  but  thinks  that  they  may  come  in  use 


With  the  thin   blade  of  a  penknife  he  poises   the  dose  on   end  and 
drops  it  upon  the  little  slip  of  paper.      \_Page  fjj.] 


THE  PRACTICE  OF  MEDICINE  133 

some  day,  perhaps  for  the  poor,  or  for  the  "colored  " 
folks.  A  delicate  pair  of  scales  lie  at  the  bottom, 
but  most  of  the  medicines  are  in  ' '  pellet "  form. 

The  old  doctor  possesses  only  a  pair  of  ' '  saddle- 
bags, "  that  have  seen  the  wear  and  tear  of  many 
winters.  They  are  warped  on  one  side,  bulged  on 
the  other,  bright  red  in  spots  from  wear,  and  a  hole 
or  two  in  sides  from  tear;  buckles  all  gone,  and 
their  place  supplied  with  twine  strings.  In  his 
1 '  case  "  there  are  but  few  drugs,  but  he  knows  the 
quality  of  each  one  of  them.  Some  are  tied  up  in 
paper,  and  the  three  or  four  vials  have  lost  their 
stoppers  and  a  wad  of  paper  has  taken  their  place. 
He  needs  no  "scales "  to  measure  out  the  dose,  for 
his  keen  eye  and  delicate  touch  has  guided  him 
through  a  long  campaign  of  many  years.  With 
the  thin  blade  of  a  penknife  he  poises  the  dose  on 
end  and  drops  it  upon  the  little  slip  of  paper  and 
wraps  it  with  a  precision  that  would  cause  the  ex- 
pert grocer  to  blush  with  shame.  Calomel,  opium, 
quinine,  buchu,  ipecac,  and  Dover's  powder  consti- 
tute his  armamentarium.  He  has  never  heard  of 
many  of  the  ' '  new-fangled  "  remedies  that  are  in 
the  ' '  case "  of  his  young  competitor,  but  he  has 
managed  to  ' '  get  along  "  these  many  years  without 
them.  After  a  decade  of  years  has  passed  over 
the  head  of  the  "young"  doctor  I  opine  that  he, 


1 34  HOW  TO  SUCCEED  IN 

too,  will  come  to  the  conclusion  that  he  can  get  along 
with  a  much  less  number  than  he  started  out  with. 
Experience.  They  say  that  experience  is  a  won- 
derful teacher,  and  so  it  is.  The  minister  of  God 
who  has  ' '  ripened  "  with  age  and  experience  won- 
ders how  it  was  in  his  young  days,  during  his  novi- 
tiate, that  he  condemned  all  who  were  "guilty" 
without  a  hearing.  He  has  learned  after  a  long 
siege  with  sin  and  the  devil  that  there  are  "miti- 
gating circumstances, "  and  that  all  is  not  sin  that 
the  preacher  denounceth.  He  has  learned  that 
example,  environment,  heredity,  circumstance, 
necessity,  association,  etc.,  play  a  great  part  in 
the  actions  of  men  and  women,  and  that  it  is  true 
charity  to  often  draw  the  veil  of  compassion,  and 
not  thrust  the  lance  of  condemnation  at  them  with- 
out a  hearing.  He  learns  by  experience  that  there 
is  a  humanity  side  to  life  as  well  as  a  spiritual  one, 
and  that  the  ' '  poor  devil "  who  is  never  given  a 
chance  to  show  the  good  that  is  in  him  is  often 
much  better  than  those  occupying  high  places,  and 
who  cry  with  a  loud  voice,  ' '  Persecute  him ! "  He 
has  learned  by  experience  that  the  Magdalen  who 
is  hissed  and  spit  upon  by  her  haughty  sister — in 
the  church  —  would  have  been  a  different  woman 
could  she  have  felt  one  heart-throb  or  been  touched 
by  the  warm  arm  of  a  sister  woman. 


THE  PRACTICE  OF  MEDICINE  135 

He  has  learned  by  experience  that  the  man  who 
wears  the  longest  face  and  utters  the  loudest  prayers 
belongs  probably  to  the  ' '  money  changers, "  and  if 
justice  were  done  would  be  driven  from  the  temple. 
It  may  be  that  he  has  learned  by  experience  that  a 
man  or  woman  whose  clothes  are  worn  by  service 
and  whose  hands  have  been  made  rough  and  ill- 
shapen  by  toil  is  not  welcome  in  the  pews  of  his 
church.  Some  Christians  (?)  prefer  to  kneel  on 
cushioned  velvet  when  sending  up  their  supplica- 
tions, and  the  presence  of  the  poor  would  molest 
them  —  during  service.  The  preacher  has  learned 
all  this  by  experience. 

The  ' '  old  doctor "  who  has  been  in  the  service 
for  a  long  time  has  learned  by  experience  that  all 
that  is  taught  in  medical  colleges  or  written  in 
medical  books  is  not  true.  He  has  learned  that 
instead  of  every  medicine  being  a  specific,  that 
there  are  no  specifics  in  medicine;  instead  of  the 
employment  of  many  drugs  in  combating  any 
certain  disease,  he  has  learned  by  experience  that 
it  is  best  to  rely  on  a  few  well  tried  ones.  He 
has  learned  that  there  are  a  great  many  shams  in 
medicine ;  that  frequently  a  loud  ' '  bray  "  is  mis- 
taken for  knowledge;  that  fine  clothes  frequently 
cover  a  hypocrite,  and  that  ' '  brass "  is  taken  for 
the  pure  metal.  He  has  seen  the  man  of  brains 


136  HOW  TO  SUCCEED  IN 

supplanted  in  the  family  by  one  whose  ideas  in 
medicine  could  be  held  on  the  point  of  a  needle. 
He  has  learned  by  experience  that  it  is  often  wise 
to  "hold  your  tongue,"  and  that  "old  women  can 
often  give  you  valuable  suggestions  "  in  medicine. 
He  is  convinced  that  merit  does  not  always  succeed, 
but  that  "Honesty  is  the  best  policy."  He  has 
been  taught  not  to  believe  everything  that  he  hears, 
and  not  to  misconstrue  what  he  sees.  He  has 
learned  by  experience  that  many  things  besides 
medicine  comfort  the  sick  and  restore  the  afflicted. 
* '  Out  of  the  mouths  of  babes  "  he  has  been  taught 
valuable  lessons,  and,  withal,  is  not  willing  to  cry 
with  the  Preacher  that  ' '  all  is  vanity. " 

The  "young  doctor"  can  learn  much  of  true 
value  by  sitting  at  the  feet  of  these  old  fathers  in 
medicine  and  profiting  by  their  experience.  Living 
within  a  few  miles  of  this  city  was  an  ' '  old  doctor " 
who  was  an  honor  to  his  neighborhood  and  a  friend 
of  the  poor.  For  nearly  a  half  century  he  lived 
among  these  people,  administering  to  their  wants 
in  a  medical  way,  and  it  is  said  of  him  that  he 
never  refused  a  ' '  call. "  It  was  always  his  pleasure 
to  assist  young  men  who  located  near  him  in  their 
efforts  to  get  practice.  Upon  one  occasion,  he  told 
me,  a  young  doctor  from  an  Eastern  State  settled 
near  his  home  and  hung  out  his  sign.  One  after- 


THE  PRACTICE  OF  MEDICINE  137 

noon  the  old  doctor  received  a  summons  to  come 
away  down  in  the  ' '  wet  woods  "  to  see  a  very  sick 
man.  Thinking  to  do  the  young  Eastern  man  a 
service,  he  told  the  messenger  that  he  was  ' '  tired 
out,"  but  that  he  would  send  a  doctor  of  great 
ability  in  his  place. 

With  this  information  the  "new  doctor"  went 
along  to  see  the  patient.  He  afterward  told  the 
old  doctor  ' '  how  things  went. "  Upon  arriving  at 
the  sick  man's  house,  he  found  him  very  sick, 
indeed ;  he  was  having  what  the  young  doctor  from 
the  East  thought  was  a  spasm-,  he  shook  from  head 
to  foot;  the  house  even  vibrated  during  the  attack, 
and  the  bed  would  move  perceptibly  each  time 
and  the  dishes  would  rattle  in  the  closet;  his  teeth 
chattered,  and  his  talk  was  not  intelligible.  After 
getting  into  him  numerous  drugs  and  several  hours 
had  passed,  the  patient  was  taken  with  a  violent 
fever.  This  the  doctor  fought  with  more  drugs 
until  the  signs  of  daylight  were  fast  approaching, 
and  seeing  no  relief  he  concluded  that  he  would 
ride  back  home  and  return  soon,  just  in  order  to 
collect  his  thoughts  and  cool  his  brow.  So  after 
ordering  that  some  additional  remedies  be  given  in 
greater  quantities  and  more  frequently,  he  took  his 
departure  with  the  kind  request  that  if  the  man 
died  before  he  could  get  back  please  inform  him. 


I$8  HOW  TO  SUCCEED  IN 

The  ride  in  the  early  morning  braced  his  nerves, 
and  after  drinking  a  cup  of  hot  coffee  he  started 
on  his  way  back.  He  could  see  in  his  imaginings 
the  cold  face  of  the  dead  man  and  hear  the  weep- 
ing of  the  widow  and  the  orphans.  Approaching 
the  house,  he  saw  a  man  ' '  chopping  "  wood  in  a 
forest  of  trees.  Riding  up  to  him,  the  following  con- 
versation took  place:  "Good  morning,  stranger," 
said  the  doctor.  "  Good  morning,"  said  the  man. 
1 '  Have  you  heard  how  the  sick  man  over  there  is 
this  morning  ?  "  asked  the  doctor.  ' '  Oh  !  he's  all 
right,"  replied  the  man.  Encouraged  by  this,  the 
doctor  proceeded  to  ask  further  concerning  the  con- 
dition of  his  patient,  while  the  man  spat  on  his 
hands  and  sent  the  ax  deep  into  the  log.  The 
chips  flew,  and  the  man  said  nothing  more  for  a  few 
minutes,  when,  with  a  twinkle  in  his  eye,  he  said, 
"Why,  Doc.,  don't  you  know  me?  I'm  that  sick 
man ;  all  I  needed  was  a  leetle  colomil  and  quinine, 
that's  what  the  'old  doctor'  always  gives  me  for 
them  chills."  The  young  doctor  learned  a  great 
deal  by  his  experience  in  this  one  case  about  — 
chills  and  fever. 

A  learned  and  distinguished  surgeon  of  this  city, 
who  died  not  many  years  ago,  was  called  in  con- 
sultation to  a  town  in  the  interior  of  the  State. 
He  was  a  fine  conversationalist,  and  lost  no  oppor- 


THE  PRACTICE  OF  MEDICINE  139 

tunity  to  talk  to  a  friend.  The  family  doctor  in 
the  case  was  a  man  of  marked  ability  and  beloved 
by  all  who  knew  him.  The  consultant  noticed  that 
during  the  entire  examination  of  the  patient  the 
family  doctor  did  not  speak  a  word.  Walking  down 
to  the  gate  together,  the  visiting  doctor  said  to  the 

family  doctor :   ' '  Dr.  P ,  if  I  had  your  manner, 

with  my  brains,  I  would  be  the  greatest  doctor  in 
America. "  If  you  are  a  young  doctor,  and  will  put 
your  knowledge  and  training  with  the  experience  of 
the  old  doctor,  you  will  be  one  of  the  best  doctors 
extant. 

Several  years  ago  an  old  ' '  grizzly  "  doctor  living 
in  the  mountains  of  Kentucky  brought  a  patient,  a 
typical  mountaineer,  to  me  to  have  done  on  him 
a  surgical  operation.  When  I  was  introduced  to 
him,  the  first  question  he  asked  was  whether  I 
belonged  to  the  church.  When  I  gave  him  an 
affirmative  answer,  he  then  desired  to  know  to 
what  denomination  I  belonged.  To  this  I  replied: 
' '  To  the  Baptist "  He  then  said  that  he  was  glad 
to  hear  it,  as  he  was  a  Baptist  also.  I  then  asked 
him  with  which  ' '  wing "  of  the  Baptist  church  he 
affiliated,  and  he  replied:  "To  the  'feet-washing' 
body."  Confessing  my  ignorance,  I  asked  him  to 
explain  to  me  the  special  ' '  creed "  of  his  church. 
He  informed  me  that  at  every  "meetin"'  the 


140  HOW  TO  SUCCEED  IN 

brethren  washed  each  others'  feet.  Leaving  him, 
I  asked  my  assistant  to  prepare  him  for  the  oper- 
ating table.  Among  other  things,  he  was  to  be 
given  a  bath.  Shortly  afterward  my  assistant  came 
laughing  into  the  room.  I  asked  him  what  amused 
him,  and  he  replied:  "I  overheard  the  religious  con- 
versation between  you  and  the  patient,  and  having 
just  given  him  a  bath,  I  am  certain  that  it  has  been 
a  long  time  since  he  attended  meetiri" 

This  may  have  been  true,  but  I  was  impressed 
with  this  man's  faith  in  the  Christian  religion.  My 
observation  of  the  people  who  live  in  the  mountains, 
at  least  in  Kentucky,  is  that  they  are  of  a  very 
religious  nature,  and  yet  there  never  was  a  class  of 
people  more  maligned  and  persecuted.  Living  as 
they  do,  in  so  simple  a  way  that  the  necessaries  of 
life  even  are  difficult  to  obtain,  yet  they  believe  in 
God,  and  molest  no  one  that  does  not  molest  them. 
Because,  forsooth,  they  in  their  ignorance  and  inno- 
cence distill  a  little  liquid  know  as  ' '  mountain  dew, " 
or  moonshine  whisky,  they  are  hunted  like  the  worst 
of  criminals  by  Government  officials,  dragged  hun- 
dreds of  miles  away  from  their  little  homes  and 
families,  confined  in  dirty  prisons  with  the  vilest 
criminals,  tried  and  sentenced  —  for  what?  That 
the  Government  of  these  great  United  States  may 
not  be  cheated  out  of  a  few  cents  of  tax.  It  is  a 


THE  PRACTICE  OF  MEDICINE  14! 

shame  that  in  this,  the  twentieth  century,  and  in 
this  Christian  country,  that  such  a  thing  is  done. 
Then,  too,  people  living  at  a  distance,  who  know 
absolutely  nothing  about  the  habits  or  conditions 
of  these  people,  denounce  them  as  thieves  and  cut- 
throats without  a  hearing.  True,  they  may  have 
their  feuds,  and  occasionally  meet  in  a  deadly  com- 
bat, but  if  the  truth  were  known  each  started  as  a 
' '  family  "  affair,  based  upon  what  one  or  the  other 
took  to  be  a  personal  insult  or  slander. 

It  is  well  known  that  they  place  a  high  estimate 
upon  the  honor  and  virtue  of  those  who  are  dear  to 
them,  and  if  needs  be  they  will  protect  both 
at  the  risk  of  their  lives.  I  have  ventured  the 
opinion  often  that  a  stranger  could  walk  through 
the  mountain  district  of  Kentucky  unarmed  and 
unattended,  and  as  long  as  he  did  not  molest  he 
would  be  taken  into  their  homes,  fed  and  bedded, 
without  a  cent  of  cost  or  any  molestation.  They  are 
more  sinned  against  than  sinning,  and  the  proper 
spirit  would  be  to  defend  and  protect  them  rather 
than  to  heap  undeserved  censure  upon  them. 

The  old  doctor  said  to  me  the  second  day  after 
the  operation  that  the  patient  had  announced 
his  intention  of  going  home  that  afternoon;  that 
if  he  was  not  permitted  to  go  he  would 
jump  out  of  the  (third  story)  window  and  make 


142  HOW  TO  SUCCEED  IN 

his  escape.  I  replied  that  it  would  be  both  dan- 
gerous and  impossible  for  him  to  attempt  to  go 
home  so  soon  after  the  operation.  The  doctor 
then  said  :  "However  that  may  be,  he  will  carry 
out  his  threat ;  I  know  the  man.  When  I  tell  you 
that  he  lives  on  top  of  a  mountain,  that  his  home 
can  not  be  reached  on  horseback,  but  only  by 
walking  up  a  hog-path;  that  his  home  consists  of 
one  room,  made  of  logs,  back  of  which  is  a  hog-pen 
connected  with  it;  that  he  has  eleven  children  and 
a  wife  who  is  feeble-minded,  you  will  wonder  that 
he  would  desire  to  leave  a  comfortable  infirmary  to 
go  back  to  it.  But  it  is  the  love  that  he  has  for 
his  family  and  his  home,  and  you  must  let  him 
take  the  risk,  or  he  will  jump  out  of  the  window 
to-night."  He  left  that  afternoon.  This  led  me 
to  ask  this  man,  whom  I  have  called  the  old 
' '  grizzly  "  doctor,  about  himself.  He  told  me  that 
he  was  sixty  years  of  age  —  he  looked  seventy-five; 
that  he  had  practiced  medicine  among  these  people 
for  over  thirty  years.  His  form  was  bent,  and  his 
skin  was  wrinkled  from  exposure  to  the  storms  of 
winter  and  the  heat  of  summer.  I  asked  him  what 
a  year's  practice  would  net  him.  He  laughed  and 
said,  "You  mean  in  money?"  "Yes,"  I  replied. 
"Nothing,  absolutely  nothing.  You  see  these 
people  are  poor,  have  no  money,  but  they  pay  me 


THE  PRACTICE  OF  MEDICINE  143 

in  odds  and  ends.  Sometimes  a  coon  skin,  a  rab- 
bit, or  squirrel,  possibly  a  stunted  calf,  a  little 
corn,  a  pumpkin,  or  it  may  be  a  small  bottle  of 
moonshine."  "  Do  any  young  doctors  ever  locate 
near  you  ? "  I  asked.  ' '  Bless  your  soul,  no, "  he 
said,  ' '  for  two  reasons  :  First,  they  could  not  make 
a  living,  for  they  would  not  be  content  to  live  as  I 
do,  and  second,  they  could  not  find  their  way 
through  the  mountains."  As  this  good  old  soldier 
in  Israel  was  talking,  I  thought  of  what  a  boon  he 
was  to  these  plain  people,  and  if  any  board  of 
health  or  examining  board  would  dare  prevent 
him  from  practicing  because  he  did  not  have  a 
"diploma"  it  would  be  guilty  of  robbing  the 
poor,  and  said  board  should  be  disbanded  by  the 
governor. 

What  a  lesson  for  the  young  doctor!  Think 
over  and  ponder  it  well,  for  from  the  example  set 
you  by  this  old  doctor  you  are  to  learn  meekness, 
fidelity,  and  unswerving  integrity.  "All  the  world's 
a  stage,  and  all  the  men  and  women  merely  play- 
ers." The  young  doctor  is  playing  the  juvenile 
part  in  his  profession,  while  the  old  doctor  has 
reached  that  age  that  ' '  shifts  into  the  lean  and 
slippered  pantaloon,  with  spectacles  on  nose  and 
pouch  on  side. "  It  is  yet  left  for  the  young  doctor 
to  play  many  parts  ;  the  old  doctor  ' '  turns  again 


144  HOW  TO  SUCCEED 

toward  childish  treble."  The  young  doctor  is 
"seeking  the  bubble  reputation";  the  old  doctor 
passes  soon  into  "second  childishness  and  mere 
oblivion."  The  young  doctor  is  "full  of  wise  saws 
and  modern  instances";  the  old  doctor  has  seen 
it  all,  and  it  is  soon  "sans  teeth,  sans  eyes,  sans 
taste,  sans  everything"  with  him.  Both  of  you, 
the  young  and  the  old  doctor,  clasp  hands  and  be 
friends. 

Partnership. —  Whether  a  young  man  should 
form  a  partnership  in  the  practice  of  medicine  is 
a  question  to  be  controlled  entirely  by  circum- 
stances. As  a  rule  it  is  much  better  not  to  do  so, 
for  the  reason  that  it  materially  hampers  one  in 
independence,  and  prevents,  to  a  great  degree,  the 
establishing  of  an  individual,  personal  reputation. 
However,  the  surroundings  may  be  of  such  a  char- 
acter, sometimes,  as  not  only  to  justify,  but  com- 
mend a  partnership. 

The  Professional  Nurse. — I  have  several  times 
in  these  pages  referred  to  the  professional  nurse. 
If  you  are  fortunate  enough  to  employ  one  of 
good  common  sense,  education,  refinement,  pure 
character,  and  sympathetic  disposition,  she  will  be 
a  great  aid  and  comfort  to  you  in  the  management 
of  the  sick. 


CHAPTER  IX 

THE  COUNTRY  VERSUS  THE  CITY  DOCTOR 

The  medical  profession  is,  or  should  be,  a  band 
of  ' '  brothers, "  united  by  ties  that  should  not  be 
broken  by  trivial  things.  No  class  of  men  is 
assailed  more,  no  class  is  so  often  persecuted, 
condemned  often  by  public  opinion  without  a  trial, 
and  censured  by  those  who  should  be  its  warmest 
advocates.  More's  the  reason  that  its  members 
should  stand  steadfast,  pursuing  a  course  of  recti- 
tude that  is  above  reproach,  protecting  those  that 
need  protection,  and  bidding  defiance  to  every  un- 
just accusation.  The  country  doctor  and  the  city 
doctor  share  alike  these  vicissitudes  that  are  inci- 
dent to  the  profession,  and  are  akin  in  every  par- 
ticular. They  only  differ  in  location.  Each  vies 
with  the  other  as  to  the  good  that  is  done  and  the 
relief  that  is  given  to  suffering  humanity.  The  one 
prefers  to  work  in  the  country,  the  other  in  the 
city,  and  thrice  blessed  is  he  that  is  content  with 
his  surroundings.  That  man  is  to  be  pitied  who  is 
constantly  changing  his  base  of  operations,  yet  is 
never  satisfied.  Truly,  a  rolling  stone  never  did 
gather  moss,  in  the  medical  profession.  If  you  are 
well  located  in  the  country,  let  well  enough  alone, 


146  HOW  TO  SUCCEED  IN 

and  remain  there.  Every  city  can  tell  the  tale  of  a 
number  of  physicians  who  were  successful  practi- 
tioners in  the  country,  surrounded  by  everything  to 
make  the  heart  glad,  but  concluded  to  move  to  the 
city.  A  few  years  only  were  necessary  in  which  to 
spend  the  accumulations  of  an  average  lifetime, 
and  they  find  themselves  bereft  of  all  they  pos- 
sessed, and  the  phantom  they  pursued  fled  and 
gone.  It  may  be  you  think  that  if  you  would 
move  to  a  city  you  would  have  a  larger  field  of  action 
and  grow  more  rapidly  in  reputation.  Think  of 

JIM  BOWKER. 

Jim  Bowker,  he  said,  if  he'd  had  a  fair  show, 
An'  a  big  enough  town  fer  his  talents  to  grow — 

Jim  Bowker,  he  said, 

He'd  fill  the  world  full  of  the  sound  of  his  name, 
And  climb  the  top  round  in  the  ladder  of  fame. 

It  may  be  jest  so; 

I  dunno; 

Jest  so  it  might  been; 

Then  again — 

But  he  had  'tarnal  luck,  everythin*  went  agin  him ; 
He  got  nary  a  show  to  start  his  beginnin' ; 

Jim  Bowker,  he  said, 

If  he'd  had  a  fair  show  ye  couldn't  tell  where  he'd  come, 
An'  the  feats  he'd  'a'  done,  an"  the  heights  he'd  a  dumb  ; 

It  may  be  jest  so; 

I  dunno; 

Jest  so  it  might  been; 

Then  again — 


THE  PRACTICE  OF  MEDICINE  147 

But  we're  all  like  Jim  Bowker,  thinks  I,  more  or  less — 
Charge  fate  for  our  bad  luck,  ourselves  for  success; 
An'  give  fortune  the  blame  for  all  our  distress 

Like  Jim  Bowker,  he  said, 
If  it  wasn't  for  luck,  an'  misfortune,  an'  sich, 
He  might  'a'  been  famous,  an'  might  'a'  been  rich. 

It  may  be  jest  so; 

I  dunno; 

Jest  so  it  might  been; 

Then  again — 

I  shall  never  forget  the  time  in  which  it  was  my 
pleasure  to  be  a  "  country  doctor. "  Every  scene 
is  hallowed  in  my  memory — and  the  childhood 
days.  The  green  grass,  the  babbling  brook,  the 
great  oak  trees,  the  mill,  and  the  old  black 
' '  mammy, "  who  has  gone  to  her  rest  these  many 
years.  The  old  school  house  and  the  ' '  master, " 
with  his  ferule  and  his  cane,  all  come  vividly  before 
me.  As  the  long  days  passed  and  the  years  went 
by,  it  was  determined  that  I  should  be  a  doctor — 
and  a  doctor  I  became.  We  often  hear  it  quoted 
that  "a  man  is  without  honor  in  his  own  country"; 
how  foolish,  indeed.  Anyway,  it  received  no 
recognition  from  me,  for  I  located  for  the  practice 
of  my  profession  at  my  ' '  old  home, "  and  to  these 
dear,  good  people  I  am  indebted  for  my  ' '  start. " 
And  they  counseled  me  and  gave  me  good  advice ; 
encouraged  me,  not  only  by  word,  but  by  deed  ;  I 
leaned  upon  them  in  trouble,  and  went  to  them  in 


148  HOW  TO  SUCCEED  IN 

distress.  Forget  them ;  not  as  long  as  I  have  life 
in  my  body  or  gratitude  in  my  heart.  So  often  do 
I  think  of  the  old  friends  and  the  old  days. 

THE  OLD  DAYS. 

Old  friends,  old  comrades,  here's  a  health, 

A  cup  of  greeting  to  you  all, 
Where'er  the  evening  shades  of  life 

Around  your  faithful  spirits  fall. 
A  hand  to  you,  a  health  to  you, 
And  golden  memory's  wealth  to  you 

For  the  old  days, 
For  the  old,  care-free  days. 

I  scarce  can  think  those  days  are  gone — 
And  yet,  like  dreams,  they  are  no  more, 

And  one  by  one  your  faces,  friends, 
Are  turning  toward  the  other  shore. 

Then  hail  to  you,  and  farewell  to  you  ! 

And  the  cups  shall  clink  a  knell  to  you 
For  the  old  days, 

For  the  old,  care-free  days. 

How  few  of  us  will  ever  meet 

Again  this  side  the  narrow  stream  ! 

And  even  if  our  hands  could  touch, 
We'd  seem  like  figures  in  a  dream. 

It's  youth,  sweet  youth,  good-bye  to  you ! 

And  we  are  ghosts  that  cry  to  you 
For  the  old  days, 

For  the  old,  care-free  days. 

Sit  quiet,  friends,  and  think  it  o'er, 

Aye,  think  how  sweet  the  old  days  were! 
Seek  not,  weep  not;  take  memory; 


THE  PRACTICE  OF  MEDICINE  149 

Let's  have  a  loving  cup  with  her — 
A  cup  with  her,  and  a  song  with  her, 
And  a  sitting  still  and  long  with  her, 

For  the  old  days, 
For  the  old,  care-free  days  ! 

Home. — Is  there  a  dearer  or  sweeter  word?  Man 
may  wander  over  the  expanse  of  the  whole  world, 
but  his  thoughts  will  go  back  to  it  in  fond  remem- 
brance, and  his  feet  turn  toward  it  as  age  creeps 
on.  The  foolish  boy  may  leave  it,  counting  his 
surroundings  as  tame  and  uninteresting;  he  may 
seek  climes  more  congenial  and  profitable,  but  as 
the  years  go  by  his  mind  is  on  his  home.  Men  in 
their  mad  pursuit  of  wealth  may  leave  it,  but  when 
disappointments  crowd  thick  and  fast  upon  them 
they  go  back  in  memory  to  the  old  home.  When 
riches  and  great  estate  come  to  him,  they  often 
feel  cumbersome  and  of  no  account,  compared  to 
the  comforts  of  his  old  home.  When  disease  and 
affliction  take  possession  of  his  body,  he  cries 
aloud  that  he  may  find  a  last  resting  place  in  his 
old  home.  Let  no  foolish  adage  drive  you  from 
home,  if  it  is  your  heart's  desire  to  locate  there, 
and  all  things  are  equal.  The  doctor's  lot,  'tis 
true,  is  not  always  a  happy  one,  but  whose  lot  is? 
Yet  there  comes  to  him  times  that  he  blesses  the 
fates  that  made  him  one,  especially  if  he  lives  in 
the  country.  The  cool  refreshing  breeze  of  the 


150  HOW  TO  SUCCEED  IN 

early  morning  recompenses  for  being  called  out 
from  a  peaceful  slumber,  and  the  stars  that 
"sparkle  and  twinkle  all  the  night  long"  give 
surcease  to  a  troubled  heart ;  and  the  pale  yet 
bright  morn  is  his  companion  during  his  long  night 
rides.  Even  when  the  night  is  dark  he  is  not 
alone,  for  the  frog  gurgles  his  hoarse  salute  as  he 
passes  on  his  way ;  the  cows  give  a  low  murmur  of 
recognition  as  he  goes  on  his  lonely  journey, 
and  the  whip-poor-will  calls  to  him  on  his  return. 
All  nature  is  asleep,  but  there  comes  to  him 
the  odor  of  new  mown  hay  and  the  delightful 
scent  from  the  hemp  field,  while  the  wild  rose, 
the  lily,  and  the  hyacinth  waft  to  him  sweet 
greetings  from  their  pure  breaths,  though  he 
sees  them  not  ;  the  dew  from  the  hill-tops  cools 
his  feverish  brow,  and  the  night  wind  sings 
to  him. 

There  the  kine  in  slumber  huddle, 
And  the  fowl  have  gone  to  rest, 
And  sweet  nature  seems  to  nourish 

All  things  living  at  her  breast ; 
Strong,  full-throated  comes  the  music 

From  the  trees  and  from  the  bog, 
And  the  leaders  in  the  chorus 
Are  the  cricket  and  the  frog ! 
O  !  the  cricket 
And  the  frog, 
In  the  grass  and 
In  the  bog — 


THE  PRACTICE  OF  MEDICINE  151 

How  their  ripply  music  soothes  one ! 
How  their  gladsome  chorus  smooths  one ! 
How  the  unisons  arise 
To  salute  the  night-garbed  skies  ! 
Just  the  cricket 
And  the  frog, 
In  the  grass  and 
In  the  bog — 

The  country  doctor,  he  is  to  be  congratulated 
that  in  his  every-day  life  he  can  commune  with 
nature,  and  he  should  thank  his  stars  that  he  is  as 
he  is.  The  city  doctor  meets  a  diff erent  scene  and 
reception  from  this  on  his  early  morning  call  to  the 
sick.  The  crowded,  overheated  city  offers  noth- 
ing to  compare  with  the  serenity  of  the  country 
in  summer.  The  doctor  dons  his  clothes,  and 
passing  out  into  the  stifling  air  concludes  to  walk 
rather  than  call  a  carriage.  It  is  said  that  the 
darkest  hour  of  night  is  the  one  just  before  the 
break  of  day,  "  the  hour  that  church-yards  yawn  "; 
it  is  also  the  stillest,  for  all  of  the  ' '  noises  of  the 
night"  have  ceased  and  the  noises  of  the  day  not 
begun,  even  in  the  city.  As  the  doctor  steps  upon 
the  street  he  hears  the  echo  of  his  own  footsteps  ; 
the  great  electric  lamp  that  hangs  swinging  across 
the  street  blinks  and  splutters,  as  if  tired  of  its 
long  night's  service.  Walking  briskly,  he  hopes  to 
escape  the  deep  shadows,  which  remind  him  of  the 
man  with  the  slungshot  secreted  about  his  person. 


I  52  HOW  TO  SUCCEED  IN 

His  call,  mayhap,  is  down  in  the  ' '  red  light "  dis- 
trict, and  he  knows  that  he  must  be  on  his  guard, 
lest  the  footpad  and  the  light-fingered  gentry  over- 
take him.  He  hears  horses'  hoofs  in  the  distance, 
and  soon  the  milk  wagon  rattles  by  him  and  the 
market  man  comes  with  his  garden  truck  fresh  for 
the  purchaser.  Passing  a  corner,  he  sees  a  door 
open  and  the  man  puts  outside  a  cuspidor  or  two, 
and  then  goes  in  again.  Glancing  in  the  door  as 
he  passes,  he  sees  heaps  of  glasses  on  a  counter 
undergoing  the  cleaning  process,  while  a  customer 
is  already  standing  at  the  "bar"  holding  in  his 
trembling  hands  a  glass  containing  the  "red 
liquor  and  aromatics,"  on  its  brim  a  piece  of 
lemon  peel.  Whizzing  by  is  the  ' '  owl  "  car  of  the 
night,  with  only  one  passenger,  and  he  —  asleep. 
A  gust  of  wind  encircles  him  with  dirt  and  he  feels 
its  hot  breath  for  a  minute,  when  it  darts  into  the 
street,  and  as  it  whirls  the  dust  around  in  one  spot 
it  seems  to  laugh  at  his  discomfiture.  Daylight 
is  gradually  taking  possession  of  the  earth,  and 
night  with  its  horrors  sulks,  then  disappears.  He 
is  absorbed  in  thought  as  he  proceeds  on  his 
way,  and  says  to  himself  what  a  wonderful  tale 
could  the  night  tell,  but  she  speaks  not,  but 
instead  throws  a  dark  mantle  over  her  devotees. 
Just  as  well,  for  it  might  be  that  many  a  Mr.  Hyde 


THE  PRACTICE  OF  MEDICINE  153 

would  be  discovered  sneaking  in  dark  corners  who 
is  playing  the  role  of  a  Doctor  Jekyl  at  home,  and 
to  whom  the  world  pays  homage.  Here  and  there 
are  seen  the  forms  of  young  girls  in  their  teens, 
going  rapidly  to  their  work  in  the  shops,  mills,  and 
stores.  He  stops  a  moment  as  he  notes  the  pale 
faces,  haggard  forms,  and  listless  expressions. 
These  girls,  many  of  them  mere  children,  who 
never  possess  a  flower  or  are  moved  by  the  strains 
of  sweet  music,  or  receive  a  kind  word  ;  whose 
lives  are  all  humdrum  ;  who  work  and  sweat  and 
sweat  and  work  all  the  live-long  day,  and  who 
receive  in  return  a  mere  pittance  for  their  labor  — 
who  can  blame  them  for  ' '  cruel "  thoughts  as 
they  see  the  fine  lady  swish  by,  holding  away  her 
silken  skirts  that  they  may  not  be  polluted  by  a 
touch  ;  who  witness  the  careful  attention  given 
other  girls  of  their  age,  who  are  dressed  in  flounces 
and  furbelows  ;  who  observe  the  carriages  of  the 
rich  go  by  at  rapid  speed,  and  they  are  commanded 
to  get  out  of  the  way  ?  Will  the  world  never  wake 
up  to  the  fact  that  this  "child  labor"  must  cease; 
that  men  and  women  are  not  dogs  that  can  be  spit 
upon,  that  an  honest  day's  labor  is  worth  more  than 
is  given  for  it,  and  that  these  people  have  souls  — 
yes,  souls,  just  as  white  and  pure  as  the  man  or 
woman  that  treats  them  as  menials  and  cheats 


I  54  HOW  TO  SUCCEED  IN 

them  of  their  true  deserts?     The  Master  taught  a 
different  lesson  from  this. 

O !  ye  who  poise  a  lordly  head 

In  haughty  gold-created  pride, 
Who  walk  the  streets  with  kingly  tread 

And  brush  the  honest  poor  aside  ; 
Who  think  the  toilers  but  the  scum 

Of  earth  and  always  in  the  way, 
Know  you  the  time  will  surely  come 

When  you  will  be  as  poor  as  they  ? 
That  death  will  level  king  and  slave  ? 

There'll  be  no  caste  beyond  the  grave. 

Hark  ye!  you  that  oppress  the  poor  and  grind 
out  the  life  of  the  helpless  in  order  to  enrich  your 
own  coffers;  there  may  yet  come  a  reckoning  that 
will  make  you  pale  with  fear  and  quake  with  dread. 

The  house  of  the  patient  is  reached,  and  a  strange 
and  horrible  sight  meets  his  eyes.  A  woman  is 
stretched  on  the  floor  in  a  pool  of  her  own  blood; 
a  deep  gash  is  revealed  in  her  neck,  and  all  life  is 
extinct.  He  stoops  down  and  examines  her,  purely 
through  form,  for  the  waxen  features,  drawn  ex- 
pression, and  marble-cold  face  have  already  told 
the  tale.  Sitting  around  on  the  floor  are  her  com- 
panions—  companions  in  sin  and  disgrace.  What 
a  strange  appearance,  indeed;  one  with  her  night 
clothes  on  has  a  red  shawl  thrown  around  her 
shoulders,  ' '  the  scarlet  woman, "  the  others  scarcely 
better  dressed.  Standing  away  from  the  rest, 


THE  PRACTICE  OF  MEDICINE  155 

looking  out  upon  the  clear,  blue  sky,  is  the  only  one 
that  has  wept  during  the  entire  tragedy;  she  seems 
so  young  and — you  must  admit  it  —  so  beautiful. 
The  daub  of  paint  is  not  on  her  cheek,  or  the  trace 
of  pencil  under  her  eyes  —  she  has  not  yet  had  to 
resort  to  that,  for  the  bloom  of  youth  that  God 
gave  her  is  yet  there  and  the  lustrous  eye  yet 
sparkles.  You  almost  feel  like  ' '  dragging  "  her  by 
force  out  of  this  hell  and  telling  her  that  she  would 
be  forgiven.  But  would  she?  The  decree  has 
gone  forth  that  she  must  have  the  finger  of  scorn 
pointed  at  her,  she  must  be  shunned  as  a  serpent, 
she  must  be  called  accursed,  her  very  heart  must  be 
torn  to  atoms  and  she  must  forever  go  her  way 
alone,  however  sad,  disconsolate,  miserable,  and 
repentant  she  is — for  has  it  not  been  so  decreed  by 
— woman  ?  ' '  Oh !  the  rarity  of  Christian  charity 
under  the  sun." 

The  Meek  and  Lowly  One  once  said,  ' '  Go,  and  sin 
no  more, "  but  ' '  society  "  hath  said,  ' '  To  hell  with 
her!"  Oh!  society,  what  sins  are  committed  in  thy 
name!  The  doctor  asks  how  it  happened.  Not  a 
word  has  been  spoken  during  all  this  time,  and  one 
woman  responds:  "Why,  you  see  it  was  this  way 
—  'Mike'  has  been  jealous  of  'Mag'  for  a  long 
time,  and  has  frequently  said  that  he  would  kill 
her;  once  he  hit  her  with  his  fist — and  poor  girl,  we 


I  56  HOW  TO  SUCCEED  IN 

thought  she  was  dead  then.  To-night  he  came 
here,  and  we  saw  that  he  was  under  the  influence 
of  liquor,  so  we  knew  there  would  be  trouble. 
Just  as  soon  as  he  caught  sight  of  'Mag'  he 
caught  her  by  the  hair,  pulled  her  head  back,  and 
cut  her  throat " — that's  all.  ' '  What  became  of 
him?"  "Well,  you  see,  we  screamed  and  the 
officer  on  the  '  beat '  came  running  in  and  caught 
Mike  just  as  he  was  running  out  of  the  back  door, 
and  he  has  taken  him  to  jail."  The  oil  lamp, 
which  has  not  been  removed,  splutters  and  goes 
out;  the  sun  looks  over  the  rim  of  the  horizon,  and 
the  doctor  takes  his  departure,  with  the  advice 
that  the  coroner  should  be  sent  for. 

A  few  days  thereafter,  if  you  had  perused  the 
morning  paper,  you  would  have  seen  the  following 
"  headlines"  :  "A  beautiful  young  girl  jumps  into 
the  river  from  the  high  bridge  at  midnight. "  ' '  The 
suicide  was  of  medium  height  and  had  dark  brown 
eyes  and  Titian  hair. "  The  doctor  recognized  the 
description  —  "one  more  unfortunate  gone  to  her 
death. "  The  country  practitioner  meets  with  many 
things  to  cheer  him  and  many  ludicrous  affairs  that 
amuse  him.  You  are  all  familiar  with  the  old 
woman  who  continually  runs  down  to  the  gate  to 
interview  the  doctor  every  time  he  passes.  The 
questions  that  she  will  ask  would  stump  a  police 


THE  PRACTICE  OF  MEDICINE  1 57 

lawyer  to  answer,  and  the  tales  of  slander  that  she 
could  tell  would  fill  a  good-sized  book,  enough  to 
ruin  any  neighborhood.  She  was  at  the  gate,  as 
usual,  early  one  morning,  when  the  doctor  rode  by 
returning  from  a  night  "call."  He  saw  that  he 
had  to  pass  her,  so  prepared  for  her  questions. 
"Oh,  doctor,"  she  called,  "  please  stop  a  minute — 
who  is  sick?"  The  doctor  replies  by  asking  a  ques- 
tion :  ' '  You  know  that  old  woman  out  in  the  Sligo 
neighborhood,  that  talks  so  much  and  slanders  so 
many  people?"  "Oh,  yes,  Mrs.  Slick."  "Yes,' 
said  the  doctor,  "that's  the  one — well,  she  was  out 
in  the  woods  talking  to  herself,  when  a  snake  saw 
his  opportunity  —  her  mouth  being  open  —  gave  a 
spring,  and  bit  her  on  the  tongue. "  ' '  Law,  doctor, 
you  don't  tell  me.  Did  it  kill  her?"  "Oh,  no! 
but  it  killed  the  snake  as  dead  as  the  devil."  The 
doctor  then  rode  on,  leaving  the  old  woman  to 
meditate.  The  old  women — God  bless  them — in 
the  country  will  often  be  a  bother  to  you,  but  don't 
ever  be  guilty  of  offending  a  single  one  of  them. 
They  mean  well,  and,  too,  let  me  say  to  you  in 
confidence,  many  will  be  the  time  that  if  you 
adopt  their  plain  and  simple  suggestions  your 
patients  will  be  the  better  off. 

On  one  occasion  a  doctor  was  in  attendance  upon 
an  obstetrical  case  that  was  proceeding  very  slowly. 


158  HOW  TO  SUCCEED  IN 

The  usual  complement  of  "old  women"  were  on 
hand  with  their  suggestions.  ' '  Doctor,  don't  you 
think  that  a  little  '  catnip '  tea  would  help  ?  You 
know  if  it  does  no  good,  it  will  do  no  harm." 
Another  recommends  that  a  little  ' '  goose  grease  " 
lightly  applied  over  the  stomach  (women  call  the 
whole  abdominal  cavity  the  stomach)  might  be  of 
great  service,  adding,  too,  ' '  if  it  does  no  good,  it  will 
do  no  harm."  The  doctor,  getting  a  little  vexed, 
said:  "Have  you  any  fresh  butter,  without  salt,  in 
the  house  ?"  ' '  No,  doctor, "  replied  the  last-spoken 
woman,  seeing  a  slight  acceptance  of  her  sugges- 
tion, ' '  but  we  can  '  churn '  some  in  a  few  minutes. " 
The  doctor,  with  a  twinkle  in  his  eye,  said:  "I 
wish  you  would. "  Out  went  the  two  women,  and 
the  way  they  did  churn  and  sweat  for  a  few  minutes 
was  a  caution.  They  came  in,  mopping  their  fore- 
heads, with  a  tablespoonful  of  "fresh"  butter  just 
as  the  baby  was  born.  ' '  Now, "  said  the  doctor, 
' '  take  that  and  apply  it  on  your  own  '  stomachs ' ; 
if  it  does  no  good,  it  will  do  no  harm. "  These  good 
old  sisters  in  Israel  do  no  harm,  but  often  do 
good.  Though  you  can  joke  them  a  little,  beware 
and  never  offer  them  sarcasm. 

There  will  be  found  in  every  county  some  one 
fellow  who  never  works,  yet  manages  to  live  very 
well,  who,  like  the  ' '  lone  fisherman, "  turns  up  on 


THE  PRACTICE  OF  MEDICINE  I  59 

all  occasions;  who  takes  a  drink  whenever  any  one 
treats;  who  never  pays  his  debts,  simply  because 
he  never  has  any  money;  who  goes  to  prayer- 
meeting  or  a  circus  just  as  occasion  requires;  who 
goes  for  the  doctor  when  the  infant  is  ushered  into 
the  world,  or  helps  dig  the  grave  of  the  man  who 
has  taken  his  departure  from  the  world ;  who  is  self- 
important,  yet  kind-hearted  withal.  A  Methodist 
minister  went  into  one  of  the  mountain  counties  to 
hold  a  ' '  revival "  meeting,  and  ran  up  against  one 
of  this  kind.  He  inquired  for  some  man  who  could 
sing  and  lead  the  choir.  After  a  vigorous  hunt  no 
one  could  be  found  who  would  attempt  it  except  Bill 
Simons,  who  thought  he  could  sing,  but  the  neigh- 
bors said  if  he  called  ' '  roaring  like  a  bull "  singing, 
why,  they  guessed  he  could.  Anyway  he  was  em- 
ployed, and  for  two  weeks  every  night  Bill  "led 
the  singing. "  The  last  night  of  the  meeting  rolled 
round,  so  Bill  ' '  filled  up  "on  "  red  liquor  "  in  order 
to  cut  a  wide  swath  that  night.  He  did  sing  with 
great  vigor,  and  at  eleven  o'clock  the  minister  said : 
' '  Brethren,  I  know  it  is  very  late — nigh  onto  eleven 
o'clock — but  what  is  time  compared  to  eternity?  In 
one  more  half  hour  we  may  save  a  soul  from  hell 
—  think  of  it,  save  a  soul  from  hell !  —  there  is  Sister 
Jones,  who  has  been  on  the  anxious  seat,  but  has 
not  yet  jined  ;  one  song  more  may  save  her  soul 


160  HOW  TO  SUCCEED  IN 

from  hell.  Brother  Simons,  won't  you  please  lead 
in  singin'?"  Bill,  thinking  that  the  singing  was  over, 
had  relapsed  into  a  partial  slumber,  but  hearing  the 
statement  with  the  request  he  stood  up,  or  ' '  leaned  " 
up,  and  said,  ' '  Waal,  I  have  been  singin'  here  for 
two  weeks,  six  or  seven  times  every  night  —  sung 
seven  times  to-night.  I  will  sing  one  more  time, 
and  if  Sister  Jones  don't  jine,  then  she  can  go  to 
hell,  as  far  as  I  am  concerned!"  Deal  gently  with 
such  a  character,  for  he  really  means  to  do  no  harm 
and  oftentimes  does  good. 

Another  personage  found  especially  in  the  South, 
and  to  whom  you  must  often  bow  with  the  most 
profound  respect,  is  the  ' '  Old  Black  Mammy. " 
Wherever  employed  she  is  an  autocrat,  and  there 
are  none  so  brave  as  dare  interfere  with  her.  It  is 
a  pity  that  those  of  her  type  are  so  fast  dying  out. 
How  well  do  I  remember  ' '  her "  in  my  boyhood 
home — she  has  long  since  gone  to  her  eternal  rest, 
yet  I  hold  for  her  a  feeling  of  reverence  and  re- 
spect. Proud,  but  not  haughty;  kind  and  attentive, 
with  a  regard  for  the  truth  that  could  not  be  shaken ; 
clean  of  character  and  person,  she  went  about 
ministering  to  and  comforting  all  members  of  the 
family,  and  hating  ' '  white  trash. "  Black  of  face, 
but  pure  of  soul;  a  slave,  yet  carefully  guarding  the 
interests  of  her  master,  and  if  ever  misfortune  or 


THE  PRACTICE  OF  MEDICINE  l6l 

ignominy  crept  into  a  family,  her  lips  were  sealed 
and  her  hands  did  caress.  A  ' '  nurse  "  that  would 
put  to  shame  many  of  the  latter-day  "profes- 
sionals, "  for  though  she  may  have  lacked  in  knowl- 
edge of  ' '  modern  methods, "  she  supplanted  them 
by  love  and  affection  for  her  sick. 

The  city  doctor  is  more  fortunate  in  many  par- 
ticulars than  his  brother  who  practices  in  the 
country.  In  the  country  it  is  a  ' '  hello  "  at  the  gate; 
in  the  city  a  ' '  hello  "  at  the  'phone ;  in  the  country 
the  doctor  saddles  his  own  horse,  in  the  city  he 
calls  a  carriage;  in  the  country  he  rides  openly 
exposed  to  the  storm  and  the  elements,  in  the  city 
he  is  protected  by  his  coupe;  in  the  country  he 
remains  until  the  patient  is  relieved,  in  the  city 
until  he  can  write  a  prescription;  in  the  country  he 
is  his  own  nurse,  in  the  city  a  professional  nurse  is 
employed;  in  the  country  he  is  glad  to  take  eggs, 
mutton,  or  chickens  in  payment  for  services,  in 
the  city  he  expects  the  cash;  in  the  country  he 
goes  clad  in  jeans  and  wears  yarn  "mittens,"  in 
the  city  he  wears  broadcloth  and  adorns  his  hands 
with  a  glove  of  kid;  in  the  country  he  is  glad  to 
get  "hog  and  hominy,"  in  the  city  he  eats  his 
meals  a  la,  carte  or  table  d*hote\  in  the  country  he 
takes  a  bath  in  the  creek  or  pond,  in  the  city  he 
bathes  in  a  porcelain  tub;  in  the  country  he  suf- 


1 62  HOW  TO  SUCCEED  IN 

fers  from  nothing  but  the  ' '  tooth-ache, "  in  the 
city  he  is  racked  with  gout  and  tormented  with 
dyspepsia;  in  the  country  he  lives  to  a  good  old 
age,  in  the  city  he  goes  to  an  early  grave;  in  the 
country  he  is  nursed  by  friends  when  sick  and 
"missed"  when  dead;  in  the  city  he  is  nursed 
by  a  "professional"  when  sick,  and  when  dead — 
well,  when  dead  the  country  doctor  and  the  city 
doctor  are  on  equal  footing  —  they  are  soon  forgot, 
and  their  ' '  accounts  "  are  left  unpaid.  The  moral 
of  all  this  is  —  that  ' '  this  is  a  very  beautiful  world 
filled  with  pleasant  people,"  and  while  life  and 
health  lasts  we  should  enjoy  ourselves  and  cease 
quarreling.  It  is  to  the  city  and  country  doctor, 
alike,  that  the  praise  is  due  of  elevating  the  medical 
profession  to  that  high  standard  which  enables  us 
to  say  that  American  medicine  is  abreast  of  the 
times,  and  is  equal  in  rank  with  the  profession  in 
any  country.  The  time  has  passed  when  it  was 
thought  necessary  for  an  American  doctor  to  go  to 
Europe  to  finish  his  education;  Europe  now  comes 
to  us.  It  is  to  the  medical  profession  of  America 
that  the  world  is  indebted  for  much  that  is  original 
in  medicine,  surgery,  and  all  the  special  branches. 
No  other  nation  claims  so  many  eminent  special- 
ists, and  the  advances  in  gynecology  alone  should 
give  to  us  the  palm  of  original  surgical  work.  No 


THE  PRACTICE  OF  MEDICINE  163 

better  instance  could  be  cited  than  the  brilliant 
achievements  in  the  operation  for  the  relief  of 
appendicitis,  and  especially  for  clearing  up  the 
pathology  of  the  same.  Let  it  be  your  earnest 
endeavor  to  keep  it  at  this  high  standard,  and  let 
your  own  name  be  registered  at  the  very  top.  No 
man  has  the  right  to  hide  his  light  "under  a 
bushel,"  and  it  should  be  remembered  that  it  is 
the  mass  of  evidence  that  counts,  and  every 
' '  atom  "  is  of  use.  Modesty  is  a  quality  much  to 
be  admired,  yet  you  can  be  so  modest  as  to  keep 
your  light  from  shining,  or  your  voice  from  ever 
being  heard.  Such  men  could  often  be  of  incalcu- 
lable service  to  their  profession,  and  yet  lose  their 
influence  from  diffidence.  Again,  there  is  a  class 
of  men  possessed  of  brains  and  genius  who 
from  a  spirit  of  lethargy,  more  properly  denomi- 
nated laziness,  allow  every  opportunity  to  pass 
without  embracing  any.  I  once  knew  a  young 
man,  a  graduate  in  medicine,  who  had  many 
qualities  to  insure  success  —  brilliant,  handsome, 
rare  intelligence,  and  wealth  at  his  command,  yet 
because  he  lacked  one  quality  —  energy — he 
amounted  to  nothing,  and  the  profession  was  not 
profited  a  whit  because  of  his  existence.  If  you 
have  intelligence,  exercise  it,  and  ' '  let  your  light  so 
shine  "  that  others  will  be  profited  by  its  effulgence. 


164  HOW  TO  SUCCEED  IN 

It  is  a  singular  fact  that  by  being  possessed  of  one 
single  fault,  however  small  it  may  appear  to  you, 
it  may  be  the  means  of  ruining  your  prospects  of 
success  in  the  medical  profession ;  as,  for  instance,  a 
sarcastic  disposition,  a  cold  exterior,  a  haughty 
bearing,  or  a  manner  of  indifference  to  the  opinion  of 
others.  Heredity  has  much  to  do  with  the  general 
make-up  of  a  man,  both  physically  and  mentally, 
yet,  by  a  strenuous  effort,  many  of  our  minor 
faults  can  be  overcome.  I  would  call  your  atten- 
tion to  the  disposition  of  some  men  to  monopolize 
everything  and  at  all  times;  who  never  allow  an 
opportunity  to  escape  to  force  themselves  upon  the 
attention  of  others.  In  conversation  they  monopo- 
lize; in  medical-society  meetings  they  are  always 
' '  on  their  feet " ;  at  prayer-meeting  or  a  horse-race 
they  are  always  busybodies;  self-important  and 
possessed  of  no  modesty,  they  excite  to  ridicule 
and  disgust.  I  am  sure  that  it  was  the  observation 
of  this  class  of  men  that  caused  the  origination  of 
that  classical  phrase,  ' '  They  make  me  tired. " 
' '  O  wad  some  pow'r  the  gif tie  gie  us  to  see  oursels 
as  others  see  us !  " 

I  would  advise  you  to  avoid  a  manner  of 
' '  brusqueness. "  It  does  not  become  a  physician, 
but  rather  the  politician,  and  him  only  after  elec- 
tion. You  are  dealing  with  the  sick;  their  minds 


THE  PRACTICE  OF  MEDICINE  165 

are  ill  at  ease,  their  nerves  shattered,  and  their 
bodies  weak  and  in  pain.  This  is  not  the  person 
to  be  treated  abruptly,  brusquely.  I  recognize  that 
there  are  times  in  a  physician's  life  when  it  would 
do  him  good  to  relieve  himself  by  the  use  of  exple- 
tives, but  during  these  spells  it  would  be  best  to  go 
to  some  quiet  room,  lock  the  door,  and  have  it  out 
with  yourself,  away  from  others.  Above  all  things, 
let  me  plead  with  you  to  be  sincere.  Sincere  in 
your  protestations  of  friendship,  your  affections, 
and  your  hatred  of  all  things  wrong.  I  have  more 
respect  for  a  man  that  would  put  his  hand  into  my 
pocket  and  steal  my  purse  than  for  the  one  who 
would  steal  my  character  under  a  blind  of  friend- 
ship. You  can  afford  to  stand  up  and  fight  an 
avowed  enemy,  and  have  a  certain  amount  of 
respect  for  him,  but  the  pretended  friend  who 
heaps  calumny  upon  you  is  a  dastardly  coward, 
and  is  beneath  the  contempt  of  a  gentleman. 
Beware  of  all  such,  and  spew  them  out  of  your 
mouth  with  an  anathema.  I  have  known  men — 
only  a  few,  thank  God — who,  under  cover  of  con- 
fidence, would  stab  to  heart  the  character  of  others 
who  had  often  befriended  them,  or  listen  with 
quiet  demeanor  to  the  recitations  of  tales  of  slan- 
der against  those  for  whom  they  pretended  a 
friendship.  Such  men  are  not  to  be  trusted,  and 


l66  HOW  TO  SUCCEED 

the  sooner  you  find  them  out  the  better.  A  friend 
is  a  friend  indeed  who  will  defend  you  against 
attack  whether  you  are  present  or  not,  but  the 
man  who  will  listen  to  vile  things  said  about  you 
and  will  not  resent  them  is  worse  than  an  enemy. 

Don't  be  a  pessimist.  The  man  who  is  a  pessi- 
mist is  distasteful  to  all  mankind  and  is  to  be 
shunned,  for  he  would  turn  every  successful  thing 
into  defeat.  Although  the  world  is  full  of  good 
men  and  women,  he  has  no  faith  in  any  one;  there 
is  no  good  in  his  fellow-man,  and  he  would  sacri- 
fice his  friend  in  his  strife  for  the  world's  goods. 
The  distressed  receive  no  help  from  him;  he  is 
selfish  and  is  wrapped  in  worldly  cares;  is  shunned 
by  children  and  grown  alike;  he  meets  trouble 
always  half  way,  and  when  yet  in  youth  is  gray 
with  age;  he  has  no  hope  or  courage,  and  when 
dead  is  not  missed. 

But,  rather,  be  an  optimist,  for  'tis  he  that  we 
all  love  to  meet.  The  day  may  seem  dark,  he  dis- 
pels it  with  good  cheer;  he  counts  the  past  as  past, 
and  has  no  regret;  he  believes  in  nature  and 
nature's  God;  hope  is  the  anchor  of  his  soul;  he 
gives  to  charity  and  counts  it  good;  he  is  a  friend 
to  children  and  does  not  make  them  afraid;  at 
maturity  he  is  happy  without  foreboding,  and  in 
old  age  he  sees  comfort  in  the  greetings  of  friends. 


CHAPTER  X 

ART  IN  MEDICINE 

Whether  the  practice  of  medicine  is  based  upon 
strictly  scientific  principles  or  not  is  yet  a  mooted 
question,  but  every  physician  knows  that  by  the 
use  of  drugs  he  is  enabled  to  quiet  pain,  to  divert  a 
fever,  control  the  secretions  of  the  body,  and  to 
save  life.  Yet  it  must  be  said  that  you  will  often 
be  disappointed  in  the  physiological  action  of  rem- 
edies, for  a  specific  for  any  disease  or  condition  is 
difficult  to  obtain.  Theories  that  were  pronounced 
facts  in  medicine  a  decade  ago  are  to-day  ignored, 
and  "  facts"  of  to-day  may  in  another  decade  be 
proven  to  be  mere  theories.  And  yet,  so  much 
is  left  us  that  is  incontrovertible  that  the  term 
1 '  science  "  is,  to  say  the  least  of  it,  not  inappropriate 
when  speaking  of  the  practice  of  medicine.  I 
would  warn  you,  however,  of  an  over-confidence  in 
drugs  and  the  acquiring  of  the  "drug  habit";  that 
is,  the  ' '  habit "  of  giving  medicines  upon  any  and 
all  occasions.  If  you  should  perchance  fall  into 
this  way  of  doing  the  people  will  meet  you  half 
way,  for  it  is  true  that  we  are  a  nation  greatly 
addicted  to  this  habit  of  taking  drugs.  Witness 
the  enormous  sale  of  proprietary  and  patent  medi- 


l68  HOW  TO  SUCCEED  IN 

cines,  and  that,  too,  without  even  a  consultation 
with  the  physician.  Especially  do  I  wish  to  warn 
you  against  the  indiscriminate  administration  of 
narcotics  per  se,  or  preparations  containing  them. 
Never  let  it  be  said  of  you  that  you  were  responsi- 
ble, even  to  a  degree,  in  making  one  opium  habi- 
tue. The  young  man  is  apt  to  start  into  the 
practice  of  medicine  ' '  laden  down  "  with  remedies 
that  after  a  few  years  of  real  observation  dwindle 
down  to  a  comparative  few.  Yet  in  no  wise  do  I 
wish  to  convey  the  impression  that  you  are  to  lose 
faith  in  drugs — far  from  it.  As  you  go  on  your 
daily  rounds,  visiting  the  sick,  it  is  your  greatest 
comfort  to  see  the  positive  proof  in  this  case  and 
in  that  of  the  efficacy  and  potency  of  the  medicines 
given.  The  saving  of  life,  of  the  attempted 
suicide,  or  accidental  poisoning;  the  stopping  of 
the  flow  of  blood  by  an  active  haemostatic;  the 
lowering  of  temperature;  the  quieting  of  pain; 
restful  slumber  to  the  sleepless;  the  activity  of 
secretion  in  sluggish  organs ;  the  gradual  return  to 
health,  all  because  of  the  proper  giving  of  medicines, 
go  to  prove  to  you  the  efficacy  of  drugs  and  com- 
fort you  in  their  administrations.  Yet  we  must  not 
forget  that  nature  is  the  great  restorer,  and  that 
oftentimes  you  are  but  the  agent  that  assists  her  in 
restoring  the  sick  to  health,  whatever  may  be  the 


THE  PRACTICE  OF  MEDICINE  169 

differences  of  opinion  in  regard  to  the  action  of 
the  one  drug  or  the  other.  Certain  it  is  that 
there  is  a  great  ' '  art "  in  the  practice  of  medicine. 
Fortunate  it  is  if  you  know  and  possess  this  art, 
for  it  will  prove  to  be  the  key  to  your  success  in 
the  practice  of  your  profession. 

Some  day  in  your  daily  rounds  you  will  meet 
with  the  ' '  old  family  doctor, "  and  you  wonder  at 
his  great  success,  oftentimes  far  surpassing  yours; 
you  with  a  college  training  and  four  years  at  medi- 
cal college ;  he  with  a  partial  common  school  educa- 
tion— if  that — and  it  may  be  one  year  at  a  medical 
school.  You  with  a  hundred  of  the  most  reliable 
remedies,  he  with  only  a  few;  you,  who  can  talk 
French,  German,  and  English,  he  that  can  not  talk 
correctly  his  native  tongue.  You  dressed  in  broad- 
cloth, with  rings  on  your  fingers  and  a  diamond 
stud;  he  in  homespun,  with  pants  in  boots  —  you 
wonder  at  his  success?  Watch  him,  and  you  will 
see.  Even  his  presence  in  the  sick-room  inspires 
confidence;  the  mother  looks  to  him  as  a  savior  of 
her  sick;  she  remembers  the  many  long  nights  that 
he  was  faithful  in  his  attentions,  and  the  times 
that  she  would  have  abandoned  all  hope  except 
for  his  consoling  words ;  the  children  look  up  to  him 
as  the  godfather,  and  the  husband  will  never  for- 
get what  a  staunch  and  true  friend  he  has  been  in 


170  HOW  TO  SUCCEED  IN 

the  hour  of  affliction.  Countenances  beam  with 
joy  and  confidence  the  moment  he  steps  within 
the  door-way,  and  the  old  women  have  an  abiding 
faith  in  him.  Faith,  what  a  world  of  meaning! 
Have  faith,  says  the  minister,  and  you  shall  be 
saved.  If  faith  can  save  a  human  soul  from  ever- 
lasting punishment,  look  what  it  can  do  for  the  liv- 
ing on  this  earth.  Out  with  pessimists  and  misan- 
thropes, who  would  have  us  believe  that  all  men  are 
bad  and  all  women  are  to  be  doubted!  What  a 
signal  failure,  indeed,  was  the  creation  of  the 
world  if  such  is  to  be  believed.  You  have  faith  in 
the  mother  who  bore  you,  in  the  father  who  begat 
you,  in  those  that  are  bound  to  you  by  filial  ties ; 
you  have  faith  in  the  man  who  has  befriended  you, 
and  call  him  friend;  you  have  faith  in  the  honor  of 
men  and  the  virtue  of  women.  It  calms  our  fears, 
begets  confidence,  and  makes  the  earth  a  beautiful 
abiding-place.  Without  it  suspicion  and  envy 
would  have  an  abiding-place  in  every  heart,  and 
life  would  be  but  a  game  of  chance.  Have  faith 
in  your  fellow-man,  and  so  live  that  he  will  have 
faith  in  you. 

Now  that  you  have  begun  the  actual  practice  of 
your  profession,  you  must  study  many  an  "object- 
lesson  "  in  order  to  become  acquainted  with  many 
things  which  will  tend  to  make  you  a  success  in 


THE  PRACTICE  OF  MEDICINE 


the  calling.  You  have  just  now  made  a  valuable 
acquisition  to  your  knowledge,  having  taken  the 
old  doctor  as  an  "object-lesson." 

For  a  while  we  will  forget  about  nauseous  drugs, 
fly-blisters,  and  cupping-glasses,  and  turn  our 
thoughts  into  more  pleasant  channels  in  order  to 
search  for  that  art  which  is  so  essential  to  your  suc- 
cess. It  is  well  with  you,  as  has  been  before 
stated,  if  you  are  a  good  judge  of  human  nature, 
and  even  if  you  so  count  yourself  there  is  much 
more  for  you  to  learn,  for  its  phases  are  as  many 
and  as  changeable  as  the  phases  of  the  moon,  and, 
I  might  add,  the  sun  and  stars.  Think  for  a 
moment  of  the  many  things  that  tend  to  make  or 
change  that  "human  nature."  "Weary  of  life 
and  tired  of  buttoning  and  unbuttoning"  was  what 
a  captain  in  Her  Majesty's  service  wrote  in  explana- 
tion of  his  suicide.  Could  his  mind  have  been 
read,  and  some  one  supplied  whose  duty  it  would  be 
to  button  and  unbutton  his  clothes,  a  life  might  have 
been  saved.  No  ;  the  student  of  '  '  human  nature  " 
sees  more  than  languor  in  the  captain's  case. 
Behind  it  was  disappointment  and  an  easy-going 
life  that  was  not  only  tiresome,  but  killing.  A  call 
to  arms  and  a  promotion  would  have  been  a 
panacea  to  him,  and  all  idea  of  suicide  would 
have  disappeared.  I  have  no  doubt  but  that  this 


172  HOW  TO  SUCCEED  IN 

splendid  officer  had,  as  a  result  of  "brooding,"  a 
coated  tongue  and  a  liver  that  would  not  act. 
Think  you  that  he  needed  physic  for  his  cure? 
Oh,  no;  the  booming  of  the  cannon  and  the  rattle 
of  musketry  is  what  he  pined  for.  Every  case 
in  practice  must  be  dealt  with  as  an  individual  case 
in  this  study  of  ' '  human  nature. "  A  young  man 
comes  to  you  filled  with  all  manner  of  complaints, 
but  you  can  find  nothing  to  account,  from  a  physi- 
cal standpoint,  for  any  of  them.  Study  the  man 
as  you  are  studying  the  case,  and  you  are  likely 
"all  of  a  sudden"  to  run  up  against  the  real  cause 
for  his  complainings.  A  lost  hope,  or  a  misfor- 
tune, it  may  be,  for  the  one  is  a  fatal  disease  and 
the  other  often  kills.  Get  the  confidence  of  this 
young  man  and  he  will  tell  you  his  story.  If  in  ill 
luck,  which  depresses,  help  him  to  attain  good 
luck,  which  prolongs  life.  Success  is  a  great  pana- 
cea. Don't  forget,  in  your  dealings  with  patients, 
that  their  worst  troubles  are  often  from  their  own 
hands.  The  timid  youth  will  consult  you  oftener 
than  the  one  endowed  with  pluck.  Polycrates  held 
that  a  plucky  man  could  bias  the  stars.  Be  this  as 
it  may,  pluck  is  a  wonderful  adjunct  in  com- 
bating diseases. 

It  is  said  by  some  that  longevity  is  a  criterion  of 
happiness.     If  this  is  true  it  is  your  duty  to  conduce 


THE  PRACTICE  OF  MEDICINE  173 

as  much  as  you  can  to  your  patients'  happiness. 
Certain  it  is  that  many  people  will  come  to  you  for 
medicine  and  you  ascertain  that  an  unhappy  con- 
dition of  the  mind  accounts  "for  it  all."  Advice 
often  is  of  more  benefit  than  medicine.  As  the 
family  doctor,  you  hold  the  key  that  unlocks  the 
closet  in  which  is  concealed  the  ''skeleton."  It 
might  be  well  that  you  enter  the  house  stealthily 
and  unlock  this  door  before  prescribing  for  your 
patient.  If  one  is  weighted  down  by  cares,  has 
had  all  hope  blasted,  whose  mind  is  tormented  in 
a  thousand  ways,  the  chance  of  cure  for  any  sup- 
posed physical  ailment  is  nil. 

First  administer  to  a  mind  diseased  and  the 
body  will  often  take  care  of  itself.  It  is  a  fact 
known  and  recognized  by  all  physicians  that  the 
will  has  much  to  do  in  the  fight  against  disease,  and 
often  controls  the  result.  This  one  idea  has  been 
grasped  by  a  sect  calling  themselves  Christian 
Scientists,  and  carried  to  a  degree  that  is  both  ludi- 
crous and  appalling.  To  say  that  the  sick  should 
be  attended  by  any  other  than  the  physician  is 
absurd,  and  the  results  show  a  most  disastrous  list 
of  deaths  caused  by  the  lack  of  proper  advice  and 
treatment.  The  very  fact,  however,  that  the  peo- 
ple clamor  for  such  and  pin  their  faith  to  such  a 
doctrine  should  teach  the  profession  not  to  neglect 


1/4  HOW  T0  SUCCEED  IN 

so  valuable  a  suggestion.  The  mind  of  any  sick 
man  or  woman  is  a  great  factor  and  should  be 
used  so  as  to  redound  to  their  benefit.  All  fear 
should  be  quieted,  longings  satisfied,  apprehensions 
allayed,  and  quiet  assured  to  the  mind  of  the  per- 
son under  treatment.  We  must  have  the  indi- 
vidual effort  of  the  patient  in  order  to  assist  nature 
and  combat  disease.  There  is  a  great  art  in 
securing  this,  for  he  must  first  have  the  most 
implicit  faith  in  you,  both  as  a  man  and  physician. 
I  pity  the  doctor  who  is  trying  to  cure  a  very  sick 
person  who  has  no  confidence  in  him  as  a  friend 
and  no  respect  for  his  ability  as  a  physician,  for  he 
is  playing  against  great  odds.  So  strong  is  the 
will  that  it  is  said  of  Edward  Trelawney,  who  was 
shot  during  the  Grecian  revolution  in  1821,  that  he 
recovered  because  he  ' '  felt  that  he  had  no  right  to 
die. "  Any  army  surgeon  of  either  one  of  our  recent 
wars  can  tell  of  the  recovery  of  many  men  who 
were  shot  just  as  severely  as  Edward  Trelawney. 
Some  recover  because  they  are  not  shot  in  a  vital 
part,  and  others  because  of  their  ' '  true  grit. "  To 
the  mind  of  the  physician  this  is  explainable, 
but  the  radical  enthusiast  runs  off  with  an  idea 
which  to  him  is  perfectly  obscure,  yet  counts 
the  result  due  to  extraneous  causes  and  not  the 
true  one. 


THE  PRACTICE  OF  MEDICINE  175 

Good  humor  has  much  to  do  in  supporting 
vitality.  I  believe  that  if  you  could  observe  two 
persons  equally  sick  with  the  same  malady,  that 
it  would  be  found  that  the  one  who  preserved  the 
most  good  humor  would  be  the  one  to  recover 
first.  Then,  too,  it  might  be  shown,  if  a  mortality 
table  could  be  collected,  that  those  of  a  sour, 
morose,  and  melancholy  disposition  do  not  live  out 
their  average  days.  Perhaps  this  is  as  nature 
intended,  for  the  world  would  be  better  off  without 
them.  It  is  said  that  the  ancient  Greeks  outlived 
us  by  about  thirty  years.  It  may  be  that  good 
humor  always  prevailed  amongst  them.  For  the 
man  who  leads  a  sedentary  life  you  will  frequently 
prescribe  a  walk  instead  of  a  pill. 

Professor  Shrodt  advocated  pedestrianism  as  a 
cure  for  all  possible  diseases.  We  can  not  accept 
this  statement  of  the  distinguished  professor,  yet 
we  can  gain  a  valuable  hint  from  his  declaration. 
Our  people  are  very  averse  to  walking,  especially 
if  they  are  able  to  ride,  and  we  know  that  this  lack 
of  exercise  breeds  many  abnormal  conditions. 
Many  a  physician  doing  practice  in  a  city  has 
shortened  his  life  by  owning  a  horse  and  buggy. 
It  was  Carlyle  who  said,  ' '  Woe  to  them  that  are 
at  ease,"  and  he  must  have  had  in  his  mind's 
eye  the  person  who  never  exercised.  You  should 


176  HOW  TO  SUCCEED  IN 

be  equally  interested  in  the  prevention  of  disease 
and  the  cure  of  the  same.  Your  duty  is  but  half 
fulfilled  if  you  neglect  this  admonition.  It  is  left 
to  you  to  teach  your  ' '  people  "  the  laws  of  health. 
In  doing  so  you  will  often  have  to  combat  old 
adages  that  are  taken  as  facts  and  superstitious 
sayings  which  are  believed  to  be  true.  If  you 
should  desire  to  have  the  well  in  your  town  closed, 
in  which  hung  the  ' '  old  oaken  bucket, "  so  violent 
would  be  the  demonstrations  that  you  would  have  to 
desist ;  your  theory  of  ' '  germs  "  would  be  laughed 
to  scorn,  and  your  patrons  desert  you  if  you 
tried  to  deprive  them  of  the  well  from  which  their 
fathers  and  grandfathers  drank.  If  you  should 
inform  them  that  it  would  be  better  for  health  if 
the  old  oak  trees  be  cut  away  from  the  windows 
in  order  to  let  the  pure,  bright  sunlight  in,  they 
would  set  you  down  as  a  simpleton  of  the  first 
water.  So  you  see  that  you  will  have  no  easy 
road  to  travel  at  first.  In  your  determination  to 
do  the  most  good  to  the  most  people  you  will 
meet  violent  opposition  from  many  whom  you 
are  trying  to  benefit,  yet  you  must  not  allow 
yourself  to  be  dissuaded  from  your  course.  The 
man  of  wealth  consults  you,  and  after  looking 
him  well  over  you  advise  him  to  sell  his  cushioned 
carriage  and  walk;  to  drink  less  champagne  and 


THE  PRACTICE  OF  MEDICINE  177 

more  water;  to  eat  corn  bread  and  hominy  instead 
of  pudding  and  pie.  See  what  a  quandary  this 
places  you  in  if  you  give  this  advice  in  lieu  of  medi- 
cine; he  thinks  you  a  fool,  and  won't  follow  it, 
and  you  run  the  risk  of  losing  his  patronage.  If 
you  do  other  than  this  you  are  not  following  the 
dictates  either  of  your  conscience  or  reason,  but 
you  will  keep  his  patronage.  Which  will  you  do? 

If  a  person  should  ask  you  for  the  four  most 
important  requisites  of  health,  you  would  not 
answer  "Opium,  quinine,  calomel,  and  ipecac," 
but  "Fresh  air,  sunlight,  regulated  diet,  and  a 
proper  amount  of  exercise"  —  three  of  them  to  be 
had  without  price,  and  the  fourth  a  money-saver. 
If  these  three  essentials  could  only  be  had  at  so 
much  per  bottle,  what  a  demand  there  would  be 
for  them,  and  what  a  price  they  would  bring!  But 
God  has  given  them  free  to  his  people  (for  are  we 
not  all  God's  people?),  and  how  the  gift  is  neg- 
lected! To  the  gormand  you  say,  Eat  less;  to  the 
ill-clad,  Dress  more;  to  the  man  who  stimulates. 
Stimulate  less;  to  the  man  who  is  overworked,  Work 
less ;  to  the  tired  woman  you  say,  Rest ;  to  the 
lethargic  girl,  Walk  more. 

A  man  went  into  the  office  of  a  distinguished 
neurologist  and  said:  "  Doctor,  every  time  I  smoke 
a  cigar  it  makes  my  heart  palpitate.  What  must 


1 78  HOW  TO  SUCCEED  IN 

I  do  for  it?"  "Don't  smoke  the  cigar,"  replied 
the  doctor,  and  because  he  charged  the  man  five 
dollars  for  this  advice  he  thought  it  too  much. 
You  can  understand  from  this  how  little  you  will  be 
paid  in  money  for  all  this  advice,  yet  you  will  be 
comforted  by  the  knowledge  that  you  have  done 
your  duty.  Besides  the  actual  giving  of  medicine, 
you  are  called  on  to  direct  the  taking  of  food.  The 
ultimate  source  of  the  whole  vital  power  of  the 
organism  is  the  supply  of  food  and  heat,  and  its 
capacity  to  avail  itself  of  these  supplies  depends 
upon  its  own  original  constitution.  You  are  to 
inform  the  patient  of  the  nature  and  destination 
of  food,  and  it  is  a  topic  worthy  of  your  best 
consideration.  The  ignorance  of  the  masses  upon 
the  most  common  physiological  facts  is  astonishing. 
You  will  find  some  who  never  eat  a  vegetable,  and 
others  who  eat  nothing  but  vegetables.  Besides  the 
nature  and  quality  of  food,  you  are  to  direct  as  to 
the  quantity.  Parents  seem  to  forget  that  a  child 
should  not  be  allowed  to  eat  as  much  a  grown 
person,  or  that  the  aged  should  be  guarded  in  the 
amount  they  eat.  It  is  disgusting,  not  to  speak  of 
the  unhealthfulness  of  the  same,  to  see  half- 
grown  boys  at  table  eat  more  than  two  men 
should  be  allowed.  I  knew  a  young  boy  who  ate 
twelve  ears  of  green  corn  for  dinner,  and  was 


THE  PRACTICE  OF  MEDICINE  179 

offended  that  his  supply  was  then  cut  off  by  his 
indulgent  parent.  Again,  it  becomes  your  duty  to 
advise  in  regard  to  the  proper  amount  of  clothing 
to  be  worn,  especially  by  the  infant.  The  tem- 
perature of  infants,  as  you  know,  is  somewhat 
higher  than  that  of  adults,  and  yet  they  are  inferior 
to  adults  in  their  power  of  resisting  cold.  Mothers, 
as  a  rule,  do  not  know  this,  and  it  is  left  with  you 
to  inform  them ;  have  the  infant  dressed  accordingly. 
You  will  often  be  appalled  at  the  actions  of  young 
girls,  who  in  their  efforts  to  bow  to  the  commands 
and  dictates  of  ' '  society  "  lose  not  only  their  health, 
but  their  lives  by  so  doing.  It  is  no  infrequent 
thing  for  a  "  society  girl "  in  midwinter  to  ' '  doff  " 
her  heavy  suit  of  the  day  and  "don"  a  light 
evening  decollete  dress  in  order  to  attend  a  recep- 
tion or  ' '  ball. "  A  gentleman  recently  told  me  of 
an  occurrence  of  this  kind  in  his  family.  His  young 
daughter  attended  a  ' '  function  "  of  this  kind,  and 
walked  home  through  a  cold  rain  with  light 
slippers  only  covering  her  feet.  The  sequel  was 
her  death.  Never  neglect  an  opportunity  to  cor- 
rect such  criminal  actions  as  these  if  in  your  power 
to  do  so.  Such  lessons  as:  The  increase  of  the 
heat  of  the  body  is  produced  by  exercise,  repose 
reduces  it;  the  influence  of  the  ingestion  of  food 
elevates  the  temperature;  the  degree  of  moisture 


ISO  HOW  TO  SUCCEED  IN 

contained  in  a  heated  atmosphere  makes  a  great 
difference  in  the  degree  of  elevation  of  tempera- 
ture which  may  be  sustained  without  inconveni- 
ence. These  facts  indicate  the  faculty  possessed 
by  the  system  of  keeping  up  its  temperature  to  an 
elevated  standard,  which  is  essential  to  health,  and 
of  preventing  it  from  being  raised  much  beyond  by 
external  heat;  simple  and  well  known  to  you, 
but  entirely  unknown  to  or  ignored  by  parents. 

In  making  up  your  mind  and  forming  a  correct 
diagnosis  of  a  case  there  are  many  things  to  be 
considered,  and  in  no  instance  should  your  action 
be  hasty.  Herein  lies  the  art  as  well  as  the 
science  of  your  profession;  study  both  well,  for 
much  depends  on  it.  The  life  of  man  is  the 
aggregate  of  the  vital  activity  of  all  its  com- 
ponent parts,  and  you  must  ascertain  the  condi- 
tions on  which  the  activity  depends.  Never  forget 
that  an  intimate  relationship  is  borne  between  each 
and  every  organ  of  the  body,  and  to  have  health 
in  the  body  as  a  whole  we  must  have  a  healthy 
condition  of  each  organ.  The  brain,  spinal  cord, 
heart,  liver,  stomach,  lungs,  etc.,  are  irritated  by 
each  other  and  irritate  in  return.  It  is  the  normal 
relationship  that  each  bears  to  the  other  that  we 
should  endeavor  to  bring  about.  This  can  be  done 
often  without  the  giving  of  medicine.  These 


THE  PRACTICE  OF  MEDICINE  l8l 

principles  and  their  application  refer  equally  to  the 
mind  as  well  as  the  body.  In  dealing  with  people 
who  come  to  you  as  patients  don't  be  misled  by 
thinking  that  if  you  care  for  his  physical  complaints 
that  the  mind  will  take  care  of  itself,  for  the  very 
reverse  of  this  may  be  true.  It  requires  great  art 
sometimes  to  ascertain  this  fact.  The  effect  of 
the  mind  over  the  body  should  be  constantly 
thought  of  in  your  dealings  with  the  sick,  for  they 
may  be  sick  in  mind,  not  body,  though  it  is  the 
latter  for  which  they  consult  you.  It  seems  never 
to  occur  to  some  men  that  the  mind  needs  rest  just 
as  the  body  does,  and  when  you,  as  a  medical  di- 
rector, undertake  to  so  advise,  they  scout  the  idea. 
The  brain  has  been  likened  to  a  galvanic  battery 
and  the  blood  to  its  exciting  liquid.  When  we 
remember  the  enormous  supply  of  blood  that  the 
brain  receives  —  as  much  as  one  fifth  of  the  whole 
arterial  stream,  sent  to  an  organ  whose  weight  does 
not  exceed  one  fortieth  that  of  the  entire  body  — 
change,  therefore,  is  continually  taking  place  in  its 
substance.  Business  men,  bankers,  merchants, 
students  go  on  at  their  work  without  intermission 
until  a  collapse  takes  place,  and  then  seek  your 
counsel.  Women  toil  night  and  day  through  many 
long,  weary  years  with  household  duties,  the  rearing 
of  children,  and  the  thousands  of  little  things  to 


1 82  HOW  TO  SUCCEED  IN 

harass  and  annoy  them,  without  any  interval  of  rest 
or  pleasure.  Even  children,  who  are  the  victims 
of  corporations  seeking  to  obtain  cheap  labor,  often 
succumb  to  this  weight  of  care.  From  the  creation 
of  the  mind  until  its  earthly  ending  it  is  ever  in  a 
fitful  state  of  unrest.  So  long  as  an  individual  is 
awake  there  is  not  a  single  moment  but  that  the 
brain  is  at  work.  Even  in  sleep  it  is  not  at  rest  — 

I  tremblingly  waked,  and,  for  a  season  after, 
Could  not  believe  but  that  I  was  in  hell ; 
Such  terrible  impression  made  my  dream. 

The  brain  is  no  exception  to  the  organic  law 
that  use  causes  decay.  The  body  undergoes  con- 
tinued change.  ' '  The  bloom  upon  the  maiden's 
cheek  is  less  to-day  than  yesterday;  her  step  is  not 
so  elastic  or  her  eye  so  bright  as  'twas  a  month 
ago.  Every  moment  shows  continued  change.  If 
this  be  true  of  the  body,  so  it  is  true  of  the  mind." 
Its  substance  is  consumed  by  every  thought,  by 
every  action  of  the  will,  by  every  sound  that  is 
heard,  by  every  object  that  is  seen,  by  every  sub- 
stance that  is  touched,  by  every  odor  that  is 
smelled,  by  every  sensation  of  pleasure  or  of  pain; 
and  so  each  instant  of  our  lives  witnesses  the 
decay  of  some  portion  of  its  mass. 

A  constant  strain  of  thought  is  a  worm  that 
gnaweth  continually.  It  is  an  established  fact 


THE  PRACTICE  OF  MEDICINE  183 

that  during  the  activity  of  the  brain  the  formation 
of  new  substance  does  not  go  on  as  rapidly  as  the 
decay  of  the  old,  hence  the  more  active  the  brain 
the  greater  the  waste.  In  speaking  upon  the  sub- 
ject of  continued  mental  strain,  Hammond  says: 
' '  If,  as  we  have  every  reason  to  believe,  each 
thought  involves  destruction  of  a  certain  amount 
of  nervous  tissue,  we  can  very  well  understand 
why,  as  we  go  forward  in  enlightenment  and  in  all 
the  elements  of  material  and  intellectual  progress, 
we  are,  at  the  same  time  (unless  we  also  advance 
in  the  knowledge  of  the  laws  of  our  being),  hurry- 
ing ourselves  with  rapid  strides  to  a  state  of 
existence  in  which  there  is  neither  waste  nor 
repair."  Dr.  Ray  says:  "The  conceptions  cease 
to  be  clear  and  well  defined,  the  power  of  endur- 
ance is  weakened,  inward  perceptions  are  con- 
founded with  outward  unhappiness,  and  illusory 
images  obtrude  themselves  unbidden  upon  the 
mind.  This  kind  of  disturbance  may  pass,  sooner 
or  later,  into  actual  insanity,  and  many  a  noble 
spirit  has  been  utterly  prostrated  by  habitual  loss 
of  rest."  It  will  be  your  mission  to  advise  and 
comfort. 

One  of  the  most  frequent  effects  of  an  overworked 
brain  is  insomnia — "sun  of  the  sleepless — melan- 
choly star! " 


184  HOW  TO  SUCCEED  IN 

Remorseless  demon  of  the  night, 
With  eyes  of  dim  and  spectral  light, 
A  vaunt!  thou  grim  ungodly  sprite — 
Insomnia. 

Pale,  restless  wraith!  'tis  gone  again, 
And  sleep  reclaims  my  fevered  brain, 
Delicious  calm  succeeds  thy  reign, 
Insomnia. 

The  peaceful  trance  is  quickly  past, 
Distempered  visions  gather  fast, 
Thy  cursed  sway's  resumed  at  last, 
Insomnia. 

The  banker  that  is  engrossed  in  thought  all  day 
lies  awake  at  night  involuntarily  adding  up  column 
after  column  of  figures,  and  the  morning  finds  him 
unrefreshed.  I  had  a  brother  who  was  for  twenty- 
six  consecutive  years  the  cashier  of  a  bank,  and 
never  had  a  holiday,  who  told  me  that  this  habit 
grew  fearfully  upon  him.  It  is  needless  to  say  that 
he  is  not  now  living. 

"As  a  truth,  it  can  be  affirmed  that  long-con- 
tinued or  excessive  intellectual  action  is  the  most 
frequent  cause  of  insomnia,  and  insomnia  is  the 
most  frequent  cause  of  cerebral  affections. "  It  has 
been  said  of  us  as  a  nation  that  we  live  too  fast. 
A  distinguished  surgeon  said  to  me  once  in  a  foreign 
hospital:  "Why  do  you  American  doctors  persist 
in  giving  chloroform  to  the  exclusion  of  all  other 
anesthetics  ?"  Before  I  had  time  to  reply,  he  added: 


THE  PRACTICE  OF  MEDICINE  185 

' '  I  suppose  it  is  because  you  are  always  in  a  hurry. " 
There  was  much  truth,  we  must  admit,  in  the  state- 
ment. It  is  a  fact  not  doubted  by  physicians  that 
the  brain  can  be  exhausted  by  intellectual  labor, 
and  nothing  short  of  a  rational  use  of  It  will  insure 
it  from  dethronement.  It  is  the  nature  of  the  mind, 
of  course,  to  work.  The  brain  that  is  kept  in  an 
inactive  state  will  become  utterly  worthless  and  its 
possessor  but  a  laggard.  But  education  and  work 
must  go  together.  Emerson,  in  1844,  in  an  essay, 
said:  "  We  are  a  student  of  words,  we  are  shut  up 
in  schools  and  colleges  for  ten  or  fifteen  years,  and 
come  out  at  last  with  a  bag  of  wind,  a  memory  of 
words,  and  do  not  know  a  thing.  We  can  not  use 
our  hands,  or  our  legs,  or  our  eyes,  or  our  arms. " 

No  more  will  the  brain  stand  to  be  overburdened 
than  the  body,  which  would  sink  under  a  heavy 
load.  The  mother  who  delights  to  show  the  acts 
of  her  precocious  child  may  live  to  see  it  an  imbecile 
because  of  her  imprudence;  minds  that  have  ruled 
nations  and  directed  armies  have  succumbed  to  the 
weight  of  care.  The  man  who  broods  continually 
over  an  imaginary  or  real  wrong  will  end  his  days 
in  a  mad- house  or  commit  a  murder.  The  death  of 
our  lamented  President  is  a  sad  confirmation  of  the 
truth  of  this.  The  person  who  continually  talks 
and  sees  but  one  way  will,  of  a  certainty,  become 


1 86  HOW  TO  SUCCEED  IN 

a  fanatic.  In  recognition  of  the  doctrine  that  the 
mind  can  become  diseased,  as  any  other  portion 
of  the  body,  and  that  by  the  term  "disordered 
mind  "  we  mean  disorder  of  its  functions,  is  it  that 
the  insane  of  to-day  are  treated  rationally.  In- 
stead of  dark  dungeons  and  heavy  irons,  they  have 
bright  homes  and  pleasant  pastimes.  Instead 
of  being  driven  from  home  and  thrust  out  of 
sight,  they  are  kept  under  the  ministration  of 
friends  and  all  their  wants  attended  to.  Thus 
we  do  "minister  to  a  mind  diseased,  pluck  from 
the  memory  a  rooted  sorrow." 

It  may  be  that  the  man  fears  that  if  he  were  to 
cease  his  constant  pursuit  of  wealth  he  might  die 
of  want.  Mayhap  it  is  that  constant  care  and 
misery  have  wasted  the  body  and  dethroned  the 
reason  of  the  unhappy  mother. 

To  the  mind  that  is  crushed  by  conscience  the 
thought  of  ' '  something  after  death "  may  drive  it 
mad.  The  loss  of  riches  or  great  estate  may  so 
burden  the  mind  that  the  reason  goes  out.  The 
lover  who  sighs  for  his  lost  one  or  is  pursued  by 
the  green-eyed  monster  is  in  danger  of  mental  ruin. 

Hence,  some  for  love,  and  some  for  jealousy, 
For  grim  religion  some,  and  some  for  pride, 
Have  lost  their  reason;  some  for  fear  of  want, 
Want  all  their  lives;  and  others  ev'ry  day, 
For  fear  of  dying,  suffer  more  than  death. 


THE  PRACTICE  OF  MEDICINE  187 

The  result  from  overtaxing  the  brain  by  what- 
ever cause  is  apparent,  and  this  class  will  form 
quite  a  proportion  of  your  practice.  You  can 
quite  understand  that  they  are  not  subjects  for 
medicine,  but  your  knowledge  teaches  you  that 
they  need  recreation,  amusement,  rest.  Again,  we 
know  that  other  organs  of  the  body  are  under 
the  direct  influence  of  mental  impressions.  The 
mouth,  heart,  functions  of  secretion,  glandular 
system,  and  the  muscular  apparatus  of  organic 
life  all  respond  to  such  impressions.  Without  any 
exercise  of  the  will  there  are  organs  whose  mus- 
cular walls  are  influenced  by  emotional  states  and 
expectant  attentions.  ' '  She  died  of  a  broken 
heart "  is  an  expression  often  heard,  and  but  too 
often  true.  A  peevish,  fretful  mind  breeds  indi- 
gestion, and  indigestion  breeds  all  the  miseries 
that  flesh  is  heir  to.  You  could  ' '  head  off " 
the  indigestion  if  you  could  see  these  people  in 
time.  The  timid  girl  that  comes  to  you  with 
palpitating  heart  is  filled  with  all  manner  of  fears 
and  anxieties.  How  very  often  is  it  that  you  have 
patients  tell  you  that  their  ' '  liver  is  out  of  order, " 
and  give,  as  a  reason,  their  gloomy  feelings.  That 
man  is  apt  to  be  in  a  merry  mood  whose  stomach 
is  ' '  with  good  capon  lined. "  It  is  proverbial  that 
a  hearty  meal  not  only  gives  strength  to  the  body 


1 88  HOW  TO  SUCCEED  IN 

but  gladness  to  the  soul.  Indeed,  it  is  the  custom 
(so  I  am  told)  with  merchants  and  other  trades- 
men to  present  their  ' '  little  bills, "  not  ' '  just  after 
the  first,"  but  just  after  dinner.  It  is  said  that 
Lord  Lyndhurst,  when  somebody  asked  him  which 
was  the  best  way  to  succeed  in  life,  replied,  ' '  Give 
good  wine."  A  French  statesman  would  have 
answered,  ' '  Give  good  dinners. "  ' '  Good  bread 
gives  clear  heads,  clear  ideas,  truth,  and  promotes 
and  leads  to  gentleness,  mercy,  charity,  and  peace. " 
It  is  believed  by  some  that  each  organ  has  its 
specific  action  or  influence  on  the  constitution  and 
functions  of  the  mind.  Be  this  as  it  may,  it  is 
certain  that  the  functions  of  the  body  must  be 
kept  in  preservation,  else  not  only  the  physical  but 
the  mental  organs  will  suffer. 

Herbert  Spencer,  at  a  dinner  given  him  by  his 
American  friends  prior  to  his  departure  for  Europe, 
after  an  extended  visit  over  the  United  States, 
said: 

"Everywhere  I  have  been  struck  with  the  num- 
ber of  faces  which  told  in  strong  lines  of  the  burden 
that  had  been  borne.  I  have  been  struck,  too, 
with  the  large  proportion  of  gray-haired  men,  and 
inquiries  have  brought  out  the  fact  that,  with  you, 
the  hair  commonly  begins  to  turn  some  ten  years 
earlier  than  with  us.  Moreover,  in  every  circle  I 


THE  PRACTICE  OF  MEDICINE  189 

have  met  men  who  had  themselves  suffered  from 
nervous  collapses,  due  to  a  stress  of  business,  or 
named  friends  who  either  killed  themselves  by 
overwork  or  had  been  permanently  incapacitated, 
or  had  wasted  long  periods  in  endeavors  to  recover 
health.  I  do  but  echo  the  opinion  of  all  observing 
persons  I  have  spoken  to,  that  immense  injury  is 
being  done  by  this  high-pressure  life;  the  physique 
is  being  undermined." 

It  stands  you  in  hand  to  give  heed  to  these 
observations  of  this  distinguished  philosopher  and 
thinker. 

If  men  who  are  daily  overtasking  their  brains  in 
their  efforts  to  gain  honor,  wealth,  and  fame  need 
rest,  what  shall  we  say  of  the  need  of  recreation 
and  amusement  for  the  women  of  the  land? 

Think  you  that  the  mother,  who  watches  through 
the  live-long  night  over  her  sick,  and  attends  to 
her  duties  of  the  day  as  well,  needs  no  rest? 
Think  you  that  the  women  who  have  the  care  of 
our  homes  and  our  families,  who  devote  all  the 
time  at  their  command  to  the  enjoyment  of  those 
they  love  and  never  for  a  moment  think  of  their 
own  happiness  or  pleasure,  need  no  rest?  Is  it 
that  we  hold  it  to  be  their  duty  only  to  comfort  the 
sick  and  attend  the  well?  How  many  noble  souls 
of  them  have  gone  to  an  early  death  for  the  want 


HOW  TO  SUCCEED  IN 

of  sympathy  and  rest?  While  they  scatter  flowers 
in  our  pathway  and  lift  many  a  burden  for  us,  do 
we  divide  the  trials  and  sorrows  that  they  bear?  It 
is  a  truth  that  they  are  better  than  we  —  more 
unselfish,  truer,  nobler,  and  purer  than  men. 
Their  burdens  should  be  lightened,  their  homes 
should  be  made  pleasant,  and  their  wants  should 
be  attended  by  us. 

There  is  another  class  that  I  desire  to  mention 
as  deserving  of  our  especial  consideration  and 
care.  I  allude  to  the  overworked  employes  in  our 
banks,  stores,  workshops,  etc. 

While  attention  is  being  paid  (and  justly  so)  to 
our  abused  and  cruelly  treated  animals,  some 
notice  should  be  given  the  ill-used  employe  who  is 
forced  to  work  an  improper  number  of  hours,  and 
that,  too,  in  badly  ventilated  rooms,  breathing  foul 
air,  endangering  and  shortening  their  lives.  Shop 
girls  sit  all  day  long,  stooping  over  sewing  machines 
and  counters  that  wear  their  life  away.  Hence, 
statistics  show  a  large  mortality  among  this  class, 
and  that,  too,  when  middle  age  is  scarcely  reached. 

Is  there  no  remedy  for  all  this? 

A  proper  number  of  hours  only  should  be  given 
them  to  work;  well  ventilated  apartments  should 
be  provided  them,  and  more  opportunities  given 
for  their  enjoyment  and  pleasure. 


THE  PRACTICE  OF  MEDICINE  19 1 

It  is  the  experience  of  the  New  York  authorities 
that  the  excursions  to  the  beach  for  the  benefit  of 
the  poor  have  done  more  for  their  enjoyment  and 
health  than  all  other  modes  of  relief.  A  pleasant 
ride,  a  merry  laugh,  a  romp  upon  the  sands,  is 
more  to  them  than  money  in  their  purse.  The 
world  is  dark  enough  to  them  at  best,  God  knows, 
so  let  every  endeavor  be  made  that  can  be  made 
for  their  relief  from  the  hardships  and  sorrows  of 
life.  You  may  say  that  these  things  are  beyond 
your  control.  I  think  not,  for  it  is  the  province  of 
the  physician  to  be  consulted  in  regard  to  all  such 
matters.  Even  if  he  should  not  be,  you  should 
exercise  the  rights  of  a  citizen  and  help  correct 
them.  You  are  to  direct  these  many  afflictions 
(for  afflictions  they  are  indeed),  and  it  will  tax 
your  very  best  energies  to  do  so.  I  have  named 
quite  a  list  of  maladies,  and  yet  but  few,  if  any,  of 
them  require  a  dose  of  medicine.  Let  your  cun- 
ning art  meet  the  exigencies  of  each  case.  Upon 
one  occasion  I  was  called  in  consultation  with  an 
elderly  physician,  of  most  perfect  manners,  to  see 
a  young  girl  who  was  very  sick.  After  the  consul- 
tation we  were  leaving  the  room,  when  she  called 
to  him  and  said :  ' '  Oh,  doctor,  you  are  leaving  and 
have  not  left  me  any  medicine."  Turning  to  her 
with  a  sweet  smile  on  his  face,  and  in  gentle  voice, 


HOW  TO  SUCCEED  IN 


he  replied  :  '  '  My  dear,  I  will  send  you  the  medi- 
cine (?)  when  I  reach  home."  The  second  day 
after,  we  called  again,  and  as  we  entered  the  room 
she  said  with  a  smile:  "I  received  your  medi- 
cine, (?)  doctor."  And  he  asked:  "How  did  you 
like  it?"  "Oh,  I  thought  Mr.  Pickwick  perfectly 
charming  !  " 

You  will  meet  with  cases  very  often  when  you 
will  be  convinced  that  medicine  will  not  effect  a 
cure  or  mitigate  the  symptoms;  where  a  book,  a 
poem,  or  a  well-told  tale  will  accomplish  much 
more.  Riding  one  day  with  a  clever  country  doc- 
tor along  a  lonely  road,  he  descended  from  his 
horse  and  plucked  a  wild  flower.  Upon  arriving  at 
the  home  of  the  patient,  who  was  a  delicate  little 
girl  of  about  eleven  summers,  he  placed  the  rose 
within  her  tiny  hand.  The  smile  of  appreciation 
that  greeted  him  evidenced  that  it  accomplished 
more  good  than  would  have  many  doses  of  nause- 
ous drugs. 

Remember,  then,  to  '  'prescribe"  a  flower,  a  pretty 
picture,  or  anything  of  beauty,  when  medicines 
fail.  Each  and  all  of  the  senses  can  be  appealed 
to  in  this  manner  and  wonders  worked.  It  is 
said  that  the  mortality  rate  has  been  perceptibly 
decreased  in  a  government  hospital  in  Paris  since 
a  band  of  music  has  been  placed  on  the  lawn  with 


THE  PRACTICE  OF  MEDICINE  193 

orders  to  play  each  day.  If  it  is  true  that  ' '  music 
hath  charms  to  soothe  a  savage  breast,"  it  also 
has  charms  to  soothe  the  sick  and  comfort  the 
afflicted.  The  mother  who  sings  her  babe  to  rest 
with  a  lullaby  may  be  giving  it  inspirations  that 
will  last  all  its  life  long.  The  lover  plays  his  lute 
beneath  the  window  of  the  girl  he  loves;  the  soldier 
marches  to  battle  and  to  death  to  the  sound  of 
martial  music;  the  deep-toned  notes  of  the  organ 
in  the  great  cathedral  bring  us  nearer  to  God; 
our  bodies  are  laid  to  rest  in  the  silent  grave  to 
the  music  of  the  solemn  dirge.  May  it  not  be  that 
they  will  rise  again  in  response  to  the  music  of 
angel  voices  and  the  harp  of  many  strings? 

The  man  that  hath  no  music  in  himself, 

Nor  is  not  moved  with  concord  of  sweet  sounds, 

Is  fit  for  treasons,  strategems  and  spoils. 


CHAPTER  XI 

SOME  RARE  TYPES  THAT  YOU  WILL  MEET 

No  trade  or  profession  exists  that  does  not  have 
some  few  in  the  ranks  that  are  an  exception  to  the 
rule.  The  medical  profession  does  not  escape  this 
classification.  There  are  men  within  its  compass 
that  "pass  muster,"  as  it  were,  but  of  whom  it  can 
be  said  that  they  are  not  up  to  the  standard  of  the 
' '  model "  doctor,  and  yet  their  faults  are  not  glar- 
ing, and  if  you  were  called  upon  to  name  them  you 
would  hesitate  before  answering;  men  who  if 
tried  before  the  "bar  of  justice,"  or  who  if  sub- 
mitted to  the  rulings  of  the  Code  of  Ethics,  would 
come  out  unscathed.  Their  little  discrepancies 
may  be  the  result  of  heredity,  association,  environ- 
ment, or  what  not,  and  their  offenses  might  better 
be  condoned  than  censured,  and  yet  their  actions 
are  often  the  subject  of  comment  by  their  con- 
fr^res.  It  is  very  like  the  abandon  that  is  the 
characteristic  of  some  men,  and  yet  they  are 
gentlemen,  and  they  would  criticise  the  same  thing 
in  others,  and  regard  themselves  as  arbiter  elegan- 
tiarum.  It  is  well,  too,  before  heaping  condem- 
nation upon  the  head  of  a  brother,  that  we  pluck 
from  our  own  eye  the  "cinder,"  if  it  be  there. 


THE  PRACTICE  OF  MEDICINE  195 

Anyway,  as  you  go  along  in  the  practice  of  your 
profession  you  are  apt  to  meet — only  occasionally, 
however — with  a  type  of  doctor  that  does  not 
exactly  come  up  to  your  ideal  of  what  a  correct 
member  of  your  profession  should  be.  Let  me  try 
to  mention  and  describe  a  few  of  them. 

The  Smooth  Doctor. — Without  trying  to  explain 
the  term  smooth  as  used  here,  you  will  readily 
understand  to  whom  reference  is  made.  To  be 
smooth  requires  certain  qualities  that  in  themselves 
are  to  be  admired,  and  yet  when  used  outside  their 
legitimate  channel  become — shall  I  say  offen- 
sive? No  dullard  could  ever  have  this  appellation 
applied  to  him,  for  it  belongs  properly  to  the  per- 
son of  shrewd  accomplishments  and  genteel  man- 
ner. No  man  that  is  rough,  either  by  heredity  or 
acquisition,  can  hope  to  be  smooth,  for  it  is  to  the 
bland  and  polished  gentleman  that  this  attribute 
belongs.  Shakespeare  had  him  in  mind  when  he 
spoke  of  the  wink  of  the  eye  and  the  nod  of  the 
head,  for  verily  he  has  both  under  most  excellent 
control.  This  type  of  man  is  well  known  in  the 
business  world,  and  especially  so  in  the  field  of 
politics.  In  the  former  he  is  looked  upon  with 
suspicion,  but  in  the  latter  he  flourishes  and  pros- 
pers, and  his  smoothness  is  accounted  both  wisdom 
and  righteousness.  The  "article"  is  sometimes 


196  HOW  TO  SUCCEED  IN 

found  in  the  medical  profession  and  escapes  recog- 
nition until  it  is  revealed  by  its  own  foulness.  The 
smooth  doctor  is  very  like  the  smooth  being  in  any 
other  calling,  suave  in  manner  and  pleasing  in 
countenance.  The  same  always  to  all  men,  never 
sincere;  full  of  flattery  as  well  as  treachery;  seem- 
ingly a  friend,  but  ready  to  desert  at  the  first  signal 
of  distress.  He  gets  your  secrets  only  to  betray 
you,  and  would  laugh  at  your  downfall  although 
his  eyes  would  be  filled  with  tears  (apparently)  of 
sympathy.  Such  a  man  is  not  to  be  trusted,  and 
you  should  steer  out  of  his  course. 

The  Eccentric  Doctor.  — Under  the  term  eccentric 
is  covered  many  follies  and  transgressions.  Many 
an  insult  has  been  offered,  and  would  have  been 
resented  as  such,  save  for  the  extenuating  expres- 
sion: "  Oh!  it  is  just  his  way,"  or,  "  Don't  mind  it; 
he  is  so  eccentric."  There  is  no  division  line 
between  sanity  and  insanity.  If  a  man  is  sane  he 
should  be  held  responsible  for  his  conduct;  if 
insane,  he  should  be  confined  in  an  insane  asylum. 
When  a  person  talks  disrespectfully  to  you,  or 
offers  an  affront  in  any  other  way,  it  is  no  justifica- 
tion to  say  of  him  that  he  is  eccentric.  If  he  is 
mad,  you  have  the  right  to  be  mad,  also.  An  Irish- 
man was  bitten  by  a  dog,  and  in  extenuation  his 
owner  said:  "Pat,  you  must  not  blame  me,  the 


THE  PRACTICE  OF  MEDICINE  197 

dog  is  mad."  "And,  begorrah,  sir,  I  am  mad, 
too!"  I  have  known  men  that  were  really  insult- 
ing in  manner,  when  there  was  no  provocation  for 
it,  and  yet  asked  to  be  excused  because  it  was  their 
way.  Nonsense!  If  a  man  is  a  gentleman  he 
should  never  forget  it,  and  if  he  does,  he  should 
be  reminded  of  it  in  a  very  forcible  way,  manner 
or  no  manner.  If  you  meet  any  such  in  your  pro- 
fessional career,  deal  with  them  as  one  man  should 
deal  with  another,  making  no  amends  on  account 
of  their  being  peculiar  or  eccentric. 

The  Political  Doctor. — As  I  have  stated  before, 
every  doctor  should  take  an  interest  in  all  current 
events,  political  and  religious  as  well  as  medical. 
The  welfare  of  your  county,  State,  and  government 
demands  this  of  you.  But  it  is  beneath  your  dig- 
nity and  calling  to  be  mixed  up  in  political  brawls, 
or  to  be  heard  howling  on  street  corners  in  defense 
of  this  candidate  or  that.  Your  influence  will  be 
felt  more  if  you  proceed  in  a  quiet  way  to 
accomplish  the  reforms  that  you  think  necessary. 
Your  clientele  will  embrace  members  of  the  differ- 
ent political  parties,  and  whereas  you  should  have 
positive  convictions,  you  should  not,  at  any  time, 
offer  insult  to  the  feelings  of  your  neighbor  or 
patron  who  happens  to  differ  with  you  in  politics. 
Do  not,  under  any  circumstances,  allow  them  to 


198  HOW  TO  SUCCEED  IN 

use  your  name  as  a  candidate  for  the  legislature, 
or  a  seat  in  Congress.  It  may  be  that  the  other 
doctor  in  the  town  is  at  the  bottom  of  the  move, 
just  to  get  you  "out  of  the  way."  Besides,  you 
must  never  forget  that  to  be  a  good  doctor  is  far 
more  dignified  and  desirable  than  to  be  a  member 
of  Congress  or  a  Federal  judge. 

The  Church  Doctor. — It  has  been  said  that 
doctors  have  been  known  to  attach  themselves  to 
certain  churches  for  the  purpose  of  gain.  I  can 
scarcely  believe  this,  for  such  a  procedure  would 
receive  condemnation  from  both  God  and  man.  It 
must  be  that  whenever  such  assertion  was  made 
some  malice,  envy,  or  jealousy  prompted  it.  We 
have  all  heard  of  the  doctor,  or  doctors,  who  pre- 
arranged for  his  being  called  out  of  church  during 
services  in  order  that  he,  or  they,  might  receive  a 
good  advertising.  How  easy  it  would  be  to  say 
such  a  thing  about  any  doctor  who  happened  to 
receive  a  call  during  this  inopportune  time.  It  is 
to  be  presumed  that  there  are  just  as  many  pious 
men  in  the  medical  profession  as  there  are  in  other 
callings,  and  it  being  their  duty  to  attend  church, 
it  is  no  one's  business  if  they  leave  the  building 
save  their  own.  If,  however,  you  should  chance  to 
get  —  in  common  parlance — the  "dead-wood"  on 
any  doctor  who  would  so  prostitute  his  calling  and 


THE  PRACTICE  OF  MEDICINE  199 

the  church  for  such  unseemly  purposes,  I  would 
advise  you  to  watch  him  in  other  things. 

The  Lodge  Doctor. — The  same  accusation  has 
been  preferred  against  doctors  in  joining  benevolent 
orders  as  has  been  said  of  them  in  attaching  them- 
selves to  the  church,  viz. :  That  they  did  it  for 
gain.  How  preposterous  the  assertion.  Is  it  that 
members  of  the  medical  profession  are  to  have  no 
rights  common  to  other  men?  Is  each  act  to  be 
called  in  question,  and  each  motive  set  down  as 
evil?  The  different  orders,  whether  they  be  for 
charity  or  benevolence,  challenge  our  admiration; 
and  if  a  doctor  desires  to  participate  in  the  same 
it  is  for  him  to  decide,  gossips  and  backbiters 
notwithstanding.  If  your  motives  are  pure  and 
your  intentions  good  carry  them  out,  never  caring 
what  idle  tongues  say.  If,  however,  you  should 
ever  be  convinced  that  a  doctor  is  trying  to  get  into 
your  lodge  for  ulterior  purposes  "black-ball"  him 
on  the  spot. 

The  "Fool"  Doctor. — This  term  is  used  for  the 
lack  of  a  better  one  that  would  express  the  mean- 
ing. There  are  some  men  in  all  professions  who 
"travel  on  their  shape,"  to  use  a  vulgar  phrase. 
It  may  be,  too,  that  they  have  some  brains,  but 
they  put  them  to  poor  use.  Their  disposition  is 
to  "strut,"  and  they  really  think  that  they  are 


2OO  HOW  TO  SUCCEED  IN 

better  than  their  fellows.  It  may  be  that  a  rela- 
tive— a  far  distant  relative — fought  in  the  War  of 
the  Revolution,  or  perhaps  his  great-grandfather 
bought  his  way  into  the  United  States  Senate,  or 
his  family  tree  shows  some  "royal"  foliage,  and 
this  begets  in  him  a  great  pride,  which  he  never 
forgets  to  put  on  " dress  parade."  Such  a  char- 
acter is  beneath  your  notice,  and  I  would  advise 
you  to  consign  him  and  his  family  tree  to  an 
eternal  oblivion. 

The  Newspaper  Doctor. — The  doctor  is  generally 
the  most  prominent  citizen  in  his  county,  and  his 
advice  is  sought  and  heeded  by  many  people.  It  is 
no  wonder,  and  certainly  not  to  his  disgrace,  if  the 
county  newspaper  should  herald  his  coming  and  his 
going.  His  intelligence  is  above  the  average,  and 
therefore  he  will  be  asked  by  the  ' '  editor  "  to  give 
his  views  for  publication  on  different  topics,  and 
there  is  no  reason  whatever  why  he  should  not  do 
so.  If  the  doctor  is  honored  by  his  professional 
brethren  by  electing  him  to  some  high  and  dignified 
office  within  their  gift  and  the  "  editor"  feels  a  just 
pride  in  the  compliment  paid  his  neighbor,  friend, 
and  fellow-citizen,  and  chronicles  the  fact  of  his 
election  in  the  columns  of  his  newspaper,  it  is  just 
and  proper,  and  it  is  a  very  narrow-minded  person 
who  would  denounce,  oppose,  or  talk  about  it  to 


THE  PRACTICE  OF  MEDICINE  2OI 

the  detriment  of  the  doctor.  But  the  man  who 
rushes  into  print  with  the  report  of  some  medical 
or  surgical  case  as  "  A  wonderful  surgical  operation 
done  by  Doctor  Hairspring  " — ' '  Never  before  at- 
tempted by  any  surgeon";  then  go  on  to  describe 
a  common,  every-day  surgical  operation,  one  that 
has  been  performed  often  by  other  doctors  in  the 
town — deserves  the  most  severe  censure.  He  is 
not  only  availing  himself  of  an  advertising  dodge, 
and  is  getting  space  in  the  paper  which  should  be 
paid  for,  but  he  is  telling  a  lie  and  is  heaping  an 
injustice  upon  his  brother  in  medicine.  It  is  need- 
less to  say  that  such  conduct  is  reprehensible. 

The  "Loud"  Doctor.  — Literally  speaking,  a 
"loud"  doctor  would  be  one  that  was  boisterous 
and  given  to  much  talk.  But  that  is  not  the  kind 
of  personage  alluded  to  here.  There  are  certain 
signs  which  speak  in  as  definite  a  tone  as  the  voice. 
It  is  a  common  expression  of  women,  in  referring  to 
certain  other  women,  that  ' '  they  dress  too  loud. " 
The  same  thing  can  be  said  of  men.  It  is  not  to  be 
understood  that  any  criticism  is  offered  upon  a  neat 
or  elegant  appearance,  but  the  doctor,  if  he  dresses 
in  accordance  with  his  calling,  will  not  appear  in 
dress  so  gaudy  as  to  attract  attention  or  call  for 
comment.  This  "loud"  habit  may  extend  to  the 
vehicle  he  drives  or  to  the  servant  by  his  side. 


2O2  HOW  TO  SUCCEED  IN 

It  is  not  befitting  a  man  whose  calling  it  is  to 
attend  the  sick  to  be  "  diked  out "  in  appearance 
that  would  do  credit  to  a  jockey  or  the  man  who 
manipulates  the  cards  in  a  faro  bank.  Yet,  after 
all,  these  are  harmless  creatures,  puffed  up  with 
their  own  vanity,  and  will  do  you  no  harm. 

The  "Crank"  Doctor. — "Cranks"  are  to  be 
found  in  all  walks  of  life.  The  business  world  is 
full  of  them,  and  you  can  scarcely  take  a  morning 
walk  without  encountering  some  of  this  class. 
From  the  man  whose  head  is  turned  on  the  ' '  mine  " 
question  to  the  one  who  has  a  simple  invention 
that  will  revolutionize  the  world,  we  will  have  such 
with  us  always.  Medicine  has  not  escaped  this 
form  of  insanity.  You  will  occasionally  meet  with 
the  man  who  has  a  sure  specific  for  many  diseases. 
He  has  thought  of  it  for  so  long,  and  tried  it  so 
often,  that  it  is  useless  to  argue  with  him.  It  may 
be  in  the  form  of  serum,  pill,  powder,  or  lymph, 
but  with  him  it  has  worked  miraculous  cures, 
although  with  you  it  has  accomplished  nothing. 
Don't  tell  him  so,  however,  for  you  will  incur  his 
displeasure  and  will  not  change  his  mind  in  the 
least.  Better  leave  him  alone  with  his  "hobby" 
and  trust  to  the  future  to  cure  him  of  his  folly. 
Fads  are  very  much  like  the  brook,  they  will  "go 
on  forever. " 


THE  PRACTICE  OF  MEDICINE  2O3 

The  "Book-worm"  Doctor. — Froude  wrote: 
' '  The  knowledge  that  a  man  can  use  is  the  only 
real  knowledge;  the  only  knowledge  that  has  life 
and  growth  in  it  and  converts  itself  into  practical 
power.  The  rest  hangs  like  dust  about  the  brain 
or  dries  like  rain-drops  off  the  stones. " 

Nothing  should  be  encouraged  more  than  the 
reading  of  good  books.  The  studious  man  is  apt 
to  be  the  successful  one  in  medicine.  But  there 
are  those  who  become  so  infatuated  by  the  habit  of 
book-reading  that  they  have  but  little  if  any  time 
in  which  to  attend  to  the  ordinary  things  in  life. 
Such  a  man  is  apt  to  become  a  mere  theorist, 
without  the  semblance  of  anything  practical  about 
him.  Such  a  person  is  not  fitted  to  the  rough-and- 
tumble,  common-sense,  every -day  life  of  the  doctor. 
He  could  tell  you,  no  doubt,  of  the  history  of  medi- 
cine from  the  most  ancient  time  to  the  present 
day,  but  he  would  be  stumped  to  tell  you  a  good 
recipe  for  the  ear-ache.  He  could  inform  you  on 
what  was  the  most  perfect  technique  for  any  major 
surgical  operation,  but  would  blunder  in  opening  a 
boil.  It  is  said  that  "a  little  learning  is  a  danger- 
ous thing,"  so  it  could  be  said  that  great  learning 
may  be  of  little  profit.  These  characters  may  do 
for  you  to  associate  with,  but  they  would  amount 
to  but  little  in  a  ' '  consultation. " 


2O4  HOW  TO  SUCCEED  IN 

The  Over-polite  Doctor. — Politeness  is  a  virtue, 
but  over-politeness  is  a  bore.  I  have  seen  men  of 
refinement  and  great  respectability  render  them- 
selves the  ' '  laughing-stock  "  of  a  company  of  ladies 
and  gentlemen  by  their  effort  to  be  polite.  One 
would  think  that  to  thank  a  friend  once  for  a  kindly 
service  was  quite  sufficient,  but  the  over-polite  man 
will  keep  on  repeating  his  thanks  for  some  trivial 
thing  until  the  donor  is  embarrassed  and  the 
listeners  disgusted.  I  have  in  mind  a  man  of  most 
genteel  appearance  and  apparent  refinement  that  so 
overdoes  everything  calling  for  politeness  that  he 
is  ridiculed  by  his  friends.  Dignity  is  one  thing 
and  an  assumed  politeness  another.  Select  the 
first  and  ignore  the  last. 

The  "Effeminate"  Doctor. — In  speaking  of  the 
"effeminate"  doctor  allusion  is  not  made  to  the 
female  doctor.  Too  much  praise  can  not  be  given 
to  the  noble  women  who  have  joined  the  ranks  of 
the  medical  profession.  Their  effort  to  do  so  was 
under  great  disadvantage,  and  their  success  has 
been  accomplished  against  immense  odds.  It  was 
first  thought  by  some  members  of  the  profession 
that  the  innovation  was  uncalled  for  and  that  women 
had  no  right  to  ask  admission  into  the  medical 
profession.  They  have  shown  us  the  contrary, 
and  by  their  genial,  lady-like  demeanor  they  have 


THE  PRACTICE  OF  MEDICINE  20$ 

purified  the  temple  of  medicine,  and  by  their  rare 
intellectual  attainments  they  have  silenced  any  and 
all  opposition.  In  a  professional  as  well  as  a 
literary  way  they  have  shown  themselves  equal  to 
men  in  the  acquisition  of  knowledge,  and  we  should 
hail  their  advent  into  this,  the  noblest  profession  of 
them  all,  with  great  pleasure.  But  he  of  effeminate 
ways,  that  bears  with  him  odors  of  the  most  deli- 
cate perfumes,  and  whose  hair  is  made  to  curl  by 
an  expert;  whose  pomades  are  fresh  from  Paris, 
and  whose  gloves  are  of  the  most  delicate  of  tints; 
whose  shirt-front  is  immaculate,  and  form  that  of  a 
Venus',  finger  nails  manicured  each  week,  and 
mustache  waxed  each  day;  rosy-cheeked,  and 
fingers  tapering  exquisitely.  Such  a  one  is  proud 
of  himself,  and  is  fit  only  for  the  ladies  to  play 
with  —  not  to  practice  medicine. 

The  Unsuccessful  Doctor. — I  mention  the  unsuc- 
cessful doctor  in  this  list  only  to  plead  with  you 
that  should  you  ever  become  acquainted  with  one 
of  this  kind  that  you  will  extend  to  him  a  helping 
hand.  The  successful  and  the  unsuccessful  doctor 
are  very  much  alike  in  one  respect.  As  long  as  a 
man  is  but  little  known,  has  made  no  reputation, 
is  in  nobody's  way,  he  is  left  severely  alone.  But 
let  him  begin  to  climb  the  ladder  of  success,  and 
the  shafts  of  envy,  jealousy,  malice,  and  hatred 


2O6  HOW  TO  SUCCEED 

will  be  shot  at  him  in  rapid  succession ;  so  with  the 
unsuccessful  man.  It  was  Josh  Billings  who  said 
that  "when  a  man  starts  down  hill  everything 
seems  greased  for  the  occasion."  Each  one  who 
passes  him  will  give  him  a  kick,  and  never  a  lift. 
You  may  find  such  a  one  in  your  profession  who 
from  drink,  misfortune,  ill-luck,  or  that  the  fates 
were  against  him,  has  not  succeeded.  Give  him  a 
lift,  encourage,  beg,  entreat,  and  if  needs  be  go 
down  in  your  pocket  and  assist  him.  There  are 
none  so  low  but  that  can  be  reclaimed,  and  the  man 
who  asks  alms  to-day  may  be  able  to  compensate 
you  to-morrow.  Some  of  the  ' '  types  "  I  have  men- 
tioned are  bad,  some  very  clever,  and  some  to  be 
condoned.  Deal  with  them  as  your  good  sense 
prompts,  but  beware  of  becoming  infected  with  any 
disease  germs,  for  possibly  some  of  these  types  are 
of  microbic  origin. 


CHAPTER  XII 

LIGHTS  AND  SHADOWS 

Whether  your  path  in  life  has  been  strewn  with 
flowers,  or  you  have  been  pricked  with  thorns; 
whether  successful  or  unsuccessful;  whether  you 
have  reached  the  goal  of  your  ambitions,  or  have 
been  always  in  the  slough  of  despondency  and 
unrest,  the  end  will  surely  come.  Some  one  has 
said  that  ' '  the  world  was  made  for  the  young. "  Be 
this  as  it  may,  it  is  certain  that  in  our  young  days 
the  foundation  is  laid  for  either  success  or  failure, 
for  happiness  or  unhappiness.  Along  with  the 
injunction  to  ' '  Remember  thy  Creator  in  the  days 
of  thy  youth  "  should  go  ' '  Remember  life  is  short, 
and  few  are  the  days  to  work."  The  young  man 
who  wastes  his  time  in  riotous  living  will  live  to  see 
the  day  that  he  repents  it.  A  robust  body  breeds 
and  sustains  a  healthy  and  working  mind,  and  the 
man  of  delicate  frame  and  ' '  weak  nerves  "  is  handi- 
capped in  the  race  of  life.  The  mind  as  well 
as  the  body  should  be  kept  in  a  tranquil  condi- 
tion, for  the  one  is  much  dependent  upon  the 
other,  as  you  well  know.  Perhaps  the  saddest 
time  in  the  life  of  man  is  in  the  realization  of 
the  fact  that  the  hour  has  come  when  he  must 


2O8  HOW  TO  SUCCEED  IN  * 

quit.  So  conservative  is  the  hand  of  nature  that 
this  time  for  retirement  creeps  by  degrees  upon 
him  and  has  seldom  a  sudden  announcement;  but 
woe  to  him  to  whom  it  does  so  come,  for  it  finds 
him  unprepared,  nothing  "laid  up  for  a  rainy 
day, "  and  the  family  left  with  no  means  of  support. 

It  is  amusing  sometimes  to  witness  the  antics 
of  the  man  who  has  passed  threescore  years,  in 
his  attempts  to  demonstrate  that  he  is  yet  in  his 
youth,  but  it  is  difficult  to  fool  the  other  old  fools; 
a  pain  in  the  back,  he  has  caught  cold;  stiff  limbs, 
caused  by  too  much  (?)  exercise;  loss  of  flesh, 
caused  by  overwork;  inability  to  sleep,  the  result 
of  mental  work;  gray  hair,  painted  black,  and 
whiskers  streaked  and  striped.  Fie!  Fie!  Old 
man,  just  as  well  "acknowledge  the  corn"  and 
shame  the  devil.  You  may  be  able  to  fight  your 
enemies  and  overcome  hardships,  but  you  can  not 
fight  old  Father  Time,  and  it  is  useless  to  try.  He 
runs  strictly  by  the  clock,  and  every  movement  of 
the  pendulum  signifies  the  passing  of  one  more 
second  of  your  life,  and  each  stroke  of  the  hour 
speaks  to  you  of  the  flight  of  time  and  the 
approach  of  death.  This  signal  is  given  you 
twenty-four  times  each  day,  so  be  up  and  a-doing. 

If  the  time  "to  quit"  is  of  so  much  sorrow  to 
man,  it  is  of  just  as  much  concern  to  woman, 


"Jack,  don't  you  think  it  is  time  to  'quit  your  thinking'  and  go  to 
bed?"  You  have  minded  that  voice  for  fifty  years,  you  will  mind  it 
now.  [Page  2irJ\ 


THE  PRACTICE  OF  MEDICINE  2OQ 

and  comes  to  her  at  an  earlier  day,  for  "of 
all  sad  words  of  tongue  or  pen"  is  to  her,  not 
"it  might  have  been,"  but  that  she  is  passt>. 
Day  by  day  she  has  watched  the  decay  of  the 
bloom  upon  her  cheek;  one  by  one  the  wrinkles 
appear;  hour  by  hour  she  sits  in  pensive  thought, 
and  each  year  brings  to  her  some  new  evidence  of 
decay.  The  deep  brown  eye  that  charmed;  the 
smile  that  entranced;  the  figure  that  bewitched; 
the  lips  of  rosy  redness  that  beguiled;  the  pearly 
teeth,  the  delicate  finger  tips,  the  tiny  foot,  these, 
all  these  have  seen  their  day  and  are  fast  showing 
signs  of  age.  Oh  !  fair  lady,  once  was  the  day 
that  gallant  men  bowed  down  to  you;  once  that 
sweet  voice  could  command  to  any  obedience,  but 
another  has  come  to  usurp  your  place  and  no  longer 
are  you  to  receive  obeisance  from  men.  Acquiesce 
in  the  dictation  of  the  fates  gracefully;  paint  not 
your  faded  cheeks  and  enamel  not  your  features; 
let  your  hair  that  was  Titian  grow  white  in  beauty, 
touched  by  nature  so  gently,  and  let  not  the  daub 
of  counterfeit  be  seen  thereon. 

Rest  not  your  soul  in  the  belief  that 

Little  gobs  of  powder, 

Little  specks  of  paint 
Make  the  little  freckle 

Look  as  if  it  ain't. 


2IO  HOW  TO  SUCCEED  IN 

Tennyson,  in  his  "Ulysses,"  shows  an  under- 
standing of  what  age  should  bring  to  a  strong  soul 
when  he  makes  that  war-worn  hero  of  many 
wanderings  and  disappointments  say  to  his  sailors: 

Tho'  much  is  taken,  much  abides  :  and  tho' 

We  are  not  now  that  strength  which  in  old  days 

Moved  earth  and  heaven  ;  that  which  we  are,  we  are ; 

One  equal  temper  of  heroic  hearts, 

Made  weak  by  time  and  fate,  but  strong  in  will 

To  strive,  to  seek,  to  find,  and  not  to  yield. 

To  grow  old  gracefully  is  the  most  perfect  charm. 
I  once  asked  an  aged  physician  what  was  left  for 
a  man  to  do  who  had  reached  the  age  of  threescore 
years  —  his  reply  was,  ' '  Books !  my  boy,  books !  " 
And  so  it  is,  and  the  man  who  has  cultivated  the 
habit  of  reading  from  his  youth  to  old  age  is  to  be 
congratulated,  for  the  time  of  peace  comes  now, 
and  rest.  Think  of  it:  the  fields  of  romance, 
history,  poetry,  and  science  open  to  him,  with  none 
to  molest.  The  sunset  of  life  can  be  made  the 
most  charming  of  all  by  its  serenity. 

They  say  that  ' '  The  young  live  in  the  future, 
the  old  in  the  past. "  I  once  heard  an  old  minister 
of  the  gospel  say,  as  he  ascended  the  pulpit:  ''My 
dear  friends,  I  know  in  my  heart  that  you  are 
pitying  the  poor  old  man,  but  let  me  say  to  you 
in  all  truth,  I  pity  you  with  all  my  soul.  I  have 


THE  PRACTICE  OF  MEDICINE  211 

almost  ended  the  fight  you  have  just  begun.  You 
know  not  what  a  terrific  struggle  it  is.  You  await 
the  plaudits  of  men,  I  await  the  benediction. "  One 
of  the  sweetest  things  left  to  those  in  retirement  is 
contemplation,  retrospection,  and  reflection.  Many 
will  be  the  times  that  you  will  live  your  life  over  in 
your  musings.  In  the  twilight  you  will  romp  and 
play  again ;  the  dear  old  faces  will  come  to  you ;  the 
games  of  your  youth;  the  admonitions  of  the  good 
old  father  and  the  embraces  of  the  sweet-faced 
mother  will  make  you  "a  child  again";  the  day 
when  you  received  your  diploma;  the  first  case;  the 
first  death ;  the  days  that  you  spent  with  your  sweet- 
heart, the  engagement,  the  wedding.  Then  the 
many  incidents  of  a  busy  life  will  crowd  upon  you, 
and  you  are  awakened  from  your  reverie  by  a  feeble 
but  pleasant  voice  asking,  "Jack,  don't  you  think 
it  is  time  to  'quit  your  thinking'  and  go  to  bed?" 
You  have  minded  that  voice  for  fifty  years,  you  will 
mind  it  now.  She  has  helped  you  to  bear  your 
burdens;  helped  you  in  gaining  a  living;  helped  you 
in  your  effort  to  gratify  your  ambition.  If  your  lot 
was  a  hard  one,  hers  was  harder;  if  you  suffered,  she 
suffered  more;  when  you  were  happy,  she  was 
happy,  and  if  you  were  bowed  down  with  grief 
she  wept.  Think,  man,  when  recounting  your  great 
deeds,  the  part  she  bore.  Let  it  not  be  always  I, 


212  HOW  TO  SUCCEED  IN 

I,  but  we,  we;  for  if  the  truth  be  told  she  deserves 
the  equal  share — yea,  more,  for  has  she  not  been 
' '  the  power  behind  the  throne  "  ? 

The  end.  All  is  silent  about  the  house;  crepe 
on  the  door;  the  neighbors  are  sitting  about  the 
lawn;  the  old  negro  servants  stand  at  the  door 
with  tears  on  their  cheeks;  not  a  word  is  spoken. 
The  black  "mammy"  is  asked  at  what  hour  it 
occurred.  She  replies  in  a  whisper,  after  using  a 
great  bandanna  handkerchief  to  wipe  the  tears 
away:  "Lor'!  honey,  nobody  knows.  I  jus' went 
into  his  room  'bout  sun-up  and  found  him  dead.  I 
jus'  thought  he  was  sleeping,  but  when  I  sed 
'Marse  Jack!'  and  he  didn't  answer  me,  I  knowed 
he  was  dead." 

' '  Peace  be  unto  you,  that  peace  the  world  knows 
not  of." 

THE  REWARD. 

To  quote  Doctor  Henry  O.  Marcy,  of  Boston: 
' '  I  would  much  prefer  to  have  a  little  '  taffy ' 
while  living  instead  of  a  great  deal  of  '  epitaphy ' 
when  I  am  dead. "  A  flower  here  and  there  during 
life  is  worth  more  than  great  piles  of  roses  on  the 
coffin;  a  lift  by  the  hand  here,  more  than  encomiums 
after  a  while.  I  have  for  a  long  time  thought  that 
the  noblest  charity  of  them  all  would  be  the  estab- 


"I  jus'  thought  he  was  sleeping,  but  when  I  sed  •  Marse  Jack  !'  and 
he  didn't  answer  me,  1  knowed  he  was  dead."      [Page  2i2.~\ 


THE  PRACTICE  OF  MEDICINE  2 13 

lishing  of  a  fund  for  the  use  of  poor,  struggling 
young  men  — just  a  little  help  at  an  opportune  time. 
Why  is  it  that  our  rich  philanthropists  do  not  think 
of  this  ?  And  who  needs  it  more  than  the  poverty- 
stricken,  but  honest,  young  men  seeking  to  get 
into  the  medical  profession  ?  The  reward  for  honest 
labor  should  come  to  the  living,  not  the  dead. 
Great  shafts  of  marble  are  erected  to  the  memory 
of  the  soldiers — right  and  good,  but  in  serving  their 
country  they  waded  through  pools  of  blood,  fresh 
from  the  veins  of  their  own  brothers:  to  the  dead 
physician  no  monument  is  erected,  though  he  fol- 
lowed in  the  wake  of  the  army  and  stayed  the  flow 
of  blood,  bound  up  broken  bones,  gave  ease  to  the 
suffering,  and  remained  with  the  dying  till  dead. 
Just  a  short  time  ago  I  had  the  pleasure  of 
walking  through  the  parks  of  a  great  city  which 
prides  itself  in  the  possession  of  many  monu- 
ments erected  in  honor  of  the  distinguished  dead. 
Here  was  one  whose  top  towered  many  feet  above 
the  earth,  in  sacred  memory  of  some  great  scien- 
tist; there  another  to  commemorate  the  death  of  a 
noted  general;  over  yonder  a  group  in  bronze  to 
mark  the  resting  place  of  unknown  soldiers,  and 
again,  a  massive  stone  to  a  statesman,  and  one  to 
the  dead  minister  of  the  gospel;  but  I  looked  in 
vain  for  one  marking  the  last  resting  place  or  to 


214  HOW  TO  SUCCEED  IN 

the  memory  of  some  good  doctor,  tho'  this  city  has 
had  within  its  walls  some  of  the  ablest  physicians 
of  the  nation.  Shame  upon  you,  oh,  ye  people  of 
little  gratitude!  In  your  last  hours  you  will  not 
call  for  the  scientist,  philanthropist,  or  statesman, 
but  for  the  doctor,  whose  claims  you  have  failed  to 
remember  even  by  the  smallest  shaft.  ' '  How  soon 
we  are  forgot "  is  written  of  all  men,  be  they  great 
or  small.  The  President  of  the  United  States  is 
shot,  suffers,  and  dies  to-day.  To-morrow  another 
takes  his  place,  and  verily  it  is  ' '  The  King  is  dead ! 
Long  live  the  King!"  Whilst  living  it  is  vouch- 
safed to  the  doctor  to  get  some  reward.  Limbs 
that  were  torn  and  shattered  were  bound  up 
by  him,  and  the  patient  lives  to  thank  him; 
the  woman  who  "lies  sick  with  a  fever,"  after 
many  long  and  weary  nights  and  hopeless  days 
recovers  and  sheds  tears  of  gratitude;  the  little 
child,  whose  life  ' '  hung  in  the  balance  "  for  many 
weeks,  comes  back  to  its  mother's  arms,  and 
fills  her  cheeks  with  kisses;  the  young  girl,  whose 
life  was  despaired  of,  sees  the  dawn  of  health 
again  and  clasps  his  hand  in  recognition;  the  wife, 
who  has  so  often  been  comforted  in  sad  hours  of 
affliction,  sends  up  her  prayers  to  the  Throne  for 
him ;  the  poor,  to  whom  he  has  always  administered 
and  never  turned  away,  heap  blessings  upon  his 


THE  PRACTICE  OF  MEDICINE  215 

head,  and  so  he  is  rewarded.  It  may  be  that  you 
do  not  live  in  "the  hearts  of  your  countrymen" 
after  you  are  dead,  but  you  receive  expressions 
from  the  hearts  of  your  patients  while  living. 
More  is  this  to  be  desired  than  heaps  of  gold,  or 
towering  shafts  of  marble,  or  figures  of  bronze. 
We  are  told  that  ' '  He  that  believeth  on  me  hath 
everlasting  life. "  Have  you  not  proven  your  faith 
by  your  works;  have  you  not,  more  surely,  followed 
the  example  of  the  Master  than  have  others,  for  have 
you  not  ' '  gone  about  doing  good, "  remembered  the 
poor — whom  you  have  had  always  with  you  — 
relieved  the  sick  and  administered  to  the  dying;  have 
you  not  been  meek  and  lowly;  have  you  not  com- 
forted the  distressed ;  have  you  not  given  when  the 
right  hand  knew  not  what  the  left  was  doing; 
for  all  these  is  there  not  some  reward?  What 
meaneth  the  passage  of  Scripture  that  reads: 
' '  Inasmuch  as  ye  have  done  it  unto  one  of  the  least 
of  these  my  brethren,  ye  have  done  it  unto  me"? 
Let  your  soul  rest  in  peace,  for  God  is  just.  After 
the  weary  life  is  over,  after  the  day  has  passed, 
aiter  the  folding  of  the  hands,  after  all  adieus, 
after  the  dark  river  is  reached,  you  will  pass  over  to 
the  other  side  to  bask  in  the  green  grass  by  the 
still  waters ;  you  will  hear  the  sweet  music  of  angel 
voices  and  join  the  ranks  of  just  men  made  perfect 


SAUNDER.S*    BOOKS 

on 

SUR.GERY 


and 


ANATOMY 


W.  B.  SAVNDERS   ®    COMPANY 

925  WALNUT  STREET  PHILADELPHIA 

9,  HENRIETTA  STREET      COVENT  GARDEN,  LONDON 


SAUNDERS'    REMARKABLE    SUCCESS 

WE  are  often  asked  to  account  for  our  extraordinary  success. 
We  can  but  point  to  modern  business  methods,  carefully  per- 
fected business  machinery,  and  unrivalled  facilities  for  distribution  of 
books.  Every  department  is  so  organized  that  the  greatest  possible 
amount  of  work  is  produced  with  the  least  waste  of  energy.  The 
representatives  of  the  firm  are  men  with  life-long  experience  in  the 
sale  of  medical  books.  Then,  too,  we  must  not  overlook  that  major 
force  in  the  modern  business  world — advertising.  We  have  a  special 
department  devoted  entirely  to  the  planning,  writing,  and  placing  of 
advertising  matter ;  and  we  might  mention  that  the  money  annually 
spent  in  advertising  now  far  exceeds  the  entire  annual  receipts  of  the 
House  during  its  earlier  years.  These  extraordinary  facilities  for  dis- 
posing of  large  editions  enable  us  to  devote  a  large  amount  of  money 
to  the  perfecting  of  every  detail  in  the  manufacture  of  books. 

A  Complete  Catalogue  of  our  Publications  will  be  Sent  upon  Request 


SAUNDERS'  BOOKS    ON 


Howard  A.  Kelly 

and  £.  HURDON  on  the 

Vermiform  Appendix 

JUST   ISSUED— AN   AUTHORITATIVE   WORK 


The  Vermiform  Appendix  and  Its  Diseases.  By  HOWARD  A. 
KELLY,  M.  D.,  Professor  of  Gynecology  in  the  Johns  Hopkins  Univer- 
sity, Baltimore;  and  E.  HURDON,  M.  D.,  Assistant  in  Gynecology  in  the 
Johns  Hopkins  University,  Baltimore.  Handsome  octavo  volume  of 
827  pages,  containing  399  superb  original  illustrations  and  3  litho- 
graphic plates.  Cloth,  $10.00  net;  Half  Morocco,  $n.oo  net. 

WITH   399   SUPERB   ORIGINAL    ILLUSTRATIONS 


This  work  is  one  of  the  most  magnificent  medical  books  ever  published,  con- 
taining some  four  hundred  beautiful  illustrations,  in  the  preparation  of  which  the 
artists  of  the  Johns  Hopkins  Hospital  have  spent  many  years.  Each  beautifully  and 
accurately  portrays  the  condition  represented,  and  together  they  form  a  magnifi- 
cent collection  unequaled  by  those  in  any  other  work  on  the  subject  ever  placed 
upon  the  market.  A  large  amount  of  original  work  has  been  done  for  the  ana- 
tomic chapter,  for  which  over  one  hundred  original  illustrations  have  been  made. 
Appendicitis  naturally  receives  the  fullest  consideration.  The  pathology  is  not 
only  amply  and  clearly  described,  but  it  is  beautifully  illuminated  with  an  abun- 
dance of  illustrations  depicting  the  pathologic  conditions  with  rare  fidelity.  Diag- 
nosis and  treatment,  by  far  the  most  important  sections  to  the  practitioner  and 
surgeon,  are  elaborately  discussed  and  profusely  illustrated.  Special  chapters  are 
devoted  to  the  peculiarities  of  appendicitis  in  children,  and  to  the  characteristics 
of  the  vermiform  appendix  in  typhoid  fever.  A  valuable  chapter  is  that  on  the 
medicolegal  status  of  appendicitis. 

British  Medical  Journal 

"  It  reaches  the  high-water  mark  of  medical  monographs,  both  in  regard  to  the  learning, 
research,  and  clinical  reasoning  of  the  text,  and  in  the  quality  of  its  illustrations.  These  are 
really  magnificent." 


SURGERY  AND   ANATOMY. 


Fowler's 
Treatise  on  Surgery 

IN  TWO  VOLUMES 


A  Treatise  on  Surgery.     By  GEORGE  R.  FOWLER,  M.  D.,  Professor 

of  Surgery  (Emeritus),  New  York  Polyclinic ;  Surgeon  to  the  Metho- 
dist Episcopal  (Seney)  Hospital,  Brooklyn  ;  Surgeon-in-Chief  to  the 
Brooklyn  Hospital.  Two  octavo  volumes  of  about  750  pages  each, 
containing  about  800  entirely  original  illustrations.' 

VOLUME   I.     READY   SOON 
WITH   400   ORIGINAL   ILLUSTRATIONS 

This  entirely  new  work  presents  the  science  and  art  of  surgery  as  it  is  prac- 
tised to-day.  The  first  part  of  the  work  deals  with  general  surgery,  and  embraces 
what  is  usually  included  under  the  head  of  principles  of  surgery.  Special  atten- 
tion is  given  to  the  subject  of  inflammation  from  the  surgeon's  point  of  view, 
due  consideration  being  accorded  the  influences  of  traumatism  and  bacterial  in- 
fection as  the  predisposing  and  exciting  causes  of  this  condition.  Then  follow 
sections  on  the  injuries  and  diseases  of  separate  tissues,  gunshot  injuries,  acute 
wound  diseases,  chronic  surgical  infections  (including  syphilis),  tumors,  surgical 
operations  in  general,  foreign  bodies,  and  bandaging.  The  second  part  of  the 
work  is  really  the  clinical  portion,  devoted  to  regional  surgery.  Herein  the 
author  especially  endeavors  to  emphasize  those  injuries  and  surgical  diseases  that 
are  of  the  greatest  importance,  not  only  because  of  their  frequency,  but  also 
because  of  the  difficulty  of  diagnosis  and  the  special  care  demanded  in  their  treat- 
ment. The  text  is  elaborately  illustrated  with  entirely  new  and  original  illustra- 
tions, neither  labor  nor  expense  having  been  spared  to  bring  this  feature  of  the 
work  up  to  the  highest  standard  of  artistic  and  practical  excellence. 


SAUNTERS'   BOOKS   ON 


Scrudder's 
Treatment  of  Fractures 

WITH   NOTES   ON  DISLOCATIONS 

The  Treatment  of  Fractures:  with  Notes  on  a  few  Common 
Dislocations.  By  CHARLES  L.  SCUDDER,  M.D.,  Surgeon  to  the  Massa- 
chusetts General  Hospital,  Boston.  Octavo  volume  of  562  pages, 
with  736  original  illustrations.  Polished  Buckram,  $5.00  net;  Half 
Morocco,  $6.00  net. 

JUST    READY  — NEW    (5th)     EDITION,     ENLARGED 
FIVE  LARGE  EDITIONS  IN  LESS  THAN  FIVE  YEARS 

Each  year  a  new  edition  of  this  remarkable  work  is  called  for,  the  new  fifth 
edition  having  just  been  issued.  Dr.  Scudder  has  made  numerous  additions 
throughout  the  text,  and  has  added  some  fifty  new  illustrations,  greatly  enhancing 
the  value  of  the  work.  The  articles  on  Dislocations,  illustrated  in  that  practical 
manner  which  has  made  Dr.  Scudder' s  work  so  useful,  will  be  found  extremely 
valuable.  The  text  has  been  brought  precisely  down  to  date,  containing  the  sur- 
geons' reports  on  the  late  wars  and  the  important  facts  regarding  fractures  pro- 
duced by  the  small-caliber  bullet.  In  the  treatment  the  reader  is  not  only  told 
but  is  shown  how  to  apply  the  apparatus,  for  as  far  as  possible,  all  the  details  are 
illustrated. 


PERSONAL  AND  PRESS  OPINIONS 

William  T.  Bull.  M.D.. 

Professor  of  Surgery,  College  of  Physicians  and  Surgeons,  New  York  City. 
"  The  work  is  a  good  one,  and  I  shall  certainly  recommend  it  to  students." 

Joseph  D.  Brya  nt,  M.D.. 

Professor  of  the  Principles  and  Practice  of  Surgery,  University  and  Bellevue  Hospital 

Medical  College,  New  York  City. 

"  As  a  practical  demonstration  of  the  topic  it  is  excellent,  and  as  an  example  of  bookrraking  it 
is  nighly  commendable." 

American  Journal  of  the  Medical  Sciences 

"  The  work  produces  a  favorable  impression  by  the  general  manner  in  which  the  subject  is 
treated.  Its  descriptions  are  concise  and  clear,  and  the  treatment  sound.  The  physical  examination  of 
the  injured  part  is  well  described,  and  .  .  .  the  method  of  making  these  examinations  is  illus 
trated  by  a  liberal  use  of  cuts." 


SURGER  Y  AND  ANA  TOMY. 


Bickha^m's 
Operative   Sxirgery 

RECENTLY  ISSUED,  2d  EDITION— TWO   EDITIONS  IN   SIX  MONTHS 

A  Text-Book  of  Operative  Surgery.  Covering  the  Surgical  Anat- 
omy and  Operative  Technic  involved  in  the  Operations  of  General 
Surgery.  For  Students  and  Practitioners.  By  WARREN  STONE 
BICKHAM,  M.D.,  Assistant  Instructor  in  Operative  Surgery,  Columbia 
University  (College  of  Physicians  and  Surgeons),  New  York.  Hand- 
some octavo  of  about  1000  pages,  with  559  beautiful  illustrations, 
nearly  all  original. 

Cloth,  $6.00  net ;  Sheep  or  Half  Morocco,  $7.00  net. 

WITH  559  BEAUTIFUL  ILLUSTRATIONS,  NEARLY  ALL  ORIGINAL 

This  absolutely  new  work  completely  covers  the  surgical  anatomy  and 
operative  technic  involved  in  the  operations  of  general  surgery.  Constructed 
on  thoroughly  new  lines,  the  discussion  of  the  subject  is  remarkably  systema- 
tized and  arranged  in  a  manner  entirely  original.  Being  the  work  of  a  teacher 
of  extensive  experience  who,  as  such,  is  thoroughly  familiar  with  the  wants  of 
students  and  general  practitioners,  the  book  is  eminently  practical  and  the  sub- 
ject treated  in  such  a  manner  as  to  render  its  comprehension  most  easy.  This 
practicability  of  the  work  is  particularly  emphasized  in  the  numerous  magnifi- 
cent illustrations  which  form  a  useful  and  striking  feature.  There  are  some  559 
of  them.  All  have  been  drawn  especially  for  this  hook,  and  they  depict  the 
pathologic  conditions  and  the  progressive  steps  in  the  various  operations 
detailed  with  unusual  fidelity,  their  artistic  and  mechanical  excellence  being  of 
the  highest  standard.  The  text  has  been  brought  precisely  down  to  the  present 
day,  all  the  recent  advances  along  the  line  of  technic  having  been  fully  discussed, 
and  elucidated  with  many  illustrations.  A  distinguishing  and  extremely  useful 
feature  is  the  treatment  of  the  anatomic  side  of  the  subject  in  connection  with 
the  operative  technic.  Anatomy  of  the  human  body  is  of  the  utmost  impor- 
tance in  the  practical  application  of  operative  surgery,  for  unless  the  surgeon 
know  the  exact  location  of  the  various  muscles,  bones,  etc.,  he  will  cause 
unnecessary  destruction  of  tissue,  and  perhaps  irreparable  injury.  The  illustra- 
tions will  be  found  of  particular  assistance  in  acquiring  this  essential  knowledge. 

NICHOLAS   SENN,  M.  D. 

Professor  of  Surgery,  Rush  Medical  College,  in  Affiliation  with  the  Univ.  of  Chicago. 

"  A  SOMEWHAT    CAREFUL    EXAMINATION    OF   THK   TEXT    AND    ILLUSTRATIONS    OF    DR. 

BICKHAM'S  BOOK  ON  OPERATIVE  SURGERY  HAS  SATISFIED  ME  OF  ITS  MERITS.     THE  BOOK 
WILL  MEET  WITH  FAVOR  ON  THE  PART  OF  TEACHERS,  STUDENTS,  AND  PRACTITIONERS." 


SAUNDERS'  BOOKS  OAT 


Moynihan's 
Abdominal  Operations 


Abdominal  Operations.  By  B.  G.  A.  MOYNIHAN,  M.  S.  (LoND.), 
F.R.C.S.,  Senior  Assistant  Surgeon,  Leeds  General  Infirmary,  England 
Octavo,  well  illustrated.  Cloth,  $7.00  net;  Half  Morocco,  $8.00  net. 

JUST   ISSUED 

It  has  been  said  of  Mr.  Moynihan  that  in  describing  details  of  operations  he 
is  at  his  best.  The  appearance  of  this,  his  latest  work,  therefore,  will  be  widely 
welcomed  by  the  medical  profession,  giving,  as  it  does,  in  most  clear  and  exact 
language,  not  only  the  actual  modus  operandi  of  the  various  abdominal  operations, 
but  also  the  preliminary  technic  of  preparation  and  sterilization.  Complications 
and  sequelae  and  after-treatment  are  presented  in  the  same  clear,  clean-cut  manner 
as  the  operations  themselves.  Peritonitis  and  appendicitis,  because  of  their  ex- 
treme importance,  have  been  accorded  unusual  consideration  in  a  work  of  this 
kind.  The  beautiful  illustrations  have  been  drawn  especially  for  Mr.  Moynihan's 
book,  and  serve  extremely  well  to  illustrate  the  text. 


Moynihan  on  Gall-stones 


Gall-stones  and  Their  Surgical  Treatment.  By  B.  G.  A.  MOYNI- 
HAN, M.  S.  (LoND.),  F.R.C.S.,  Senior  Assistant  Surgeon,  Leeds  General 
Infirmary,  England.  Octavo  of  400  pages,  fully  illustrated. 

JUST  ISSUED— NEW  (2d)  EDITION 

Mr.  Moynihan,  in  revising  his  book,  has  made  many  additions  to  the  text,  so 
as  to  include  the  most  recent  advances.  Especial  attention  has  been  given  to  a 
detailed  description  of  the  early  symptoms  in  cholelithiasis,  enabling  a  diagnosis 
to  be  made  in  the  stage  in  which  surgical  treatment  can  be  most  safely  adopted. 
Every  phrase  of  gall-stone  disease  is  dealt  with,  and  is  illustrated  by  a  large 
number  of  clinical  records.  The  account  of  the  operative  treatment  of  all  the 
forms  and  complications  of  gall-stone  disease  is  full  and  accurate.  A  number  of 
the  illustrations  are  in  color. 

British  Medical  Journal 

"  He  expresses  his  views  with  admirable  clearness,  and  he  supports  them  by  a  large  num- 
ber of  clinical  examples,  which  will  be  much  prized  by  those  who  know  the  difficult  problems 
and  tasks  which  gall-stone  surgery  not  infrequently  presents." 


SURGER  Y  AND  ANA  TOMY 


Irvterrvatiorval 
Text-Book  of  Surgery 

SECOND  EDITION,  THOROUGHLY  REVISED  AND  ENLARGED 

The  International  Text-Book  of  Surgery.  In  two  volumes.  By 
American  and  British  authors.  Edited  by  J.  COLLINS  WARREN,  M.D., 
LL.D.,  F.R.C.S.  (Hon.),  Professor  of  Surgery,  Harvard  Medical 
School ;  and  A.  PEARCE  GOULD,  M.S.,  F.R.C.S.,  of  London,  England. — 
Vol.  I.  General  and  Operative  Surgery.  Royal  octavo,  975  pages, 
461  illustrations,  9  full-page  colored  plates. — Vol.  II.  Special  or 
Regional  Surgery.  Royal  octavo,  1122  pages,  499  illustrations,  and 
8  full-page  colored  plates. 

Per  volume  :  Cloth,  $5.00  net;  Half  Morocco,  $6.00  net 

ADOPTED  BY  THE  U.  S.  ARMY 

In  this  new  edition  the  entire  book  has  been  carefully  revised,  and  special  effort 
has  been  made  to  bring  the  work  down  to  the  present  day.  The  chapters  on 
Military  and  Naval  Surgery  have  been  very  carefully  revised  and  extensively 
rewritten  in  the  light  of  the  knowledge  gained  during  the  recent  wars.  The 
articles  on  the  effect  upon  the  human  body  of  the  various  kinds  of  bullets,  and 
the  results  of  surgery  in  the  field  are  based  on  the  latest  reports  of  the  sur- 
geons in  the  field.  The  chapter  on  Diseases  of  the  Lymphatic  System  has  been 
completely  rewritten  and  brought  up  to  date ;  and  of  special  interest  is  the 
chapter  on  the  Spleen.  The  already  numerous  and  beautiful  illustrations  have 
been  greatly  increased,  constituting  a  valuable  feature,  especially  so  the  seven- 
teen colored  lithographic  plates. 


OPINIONS  OF  THE  MEDICAL  PRESS 

AnnaJs  of  Surgery 

"  It  is  the  most  valuable  work  on  the  subject  that  has  appeared  in  some  years.  The  clinician  and 
the  pathologist  have  joined  hands  in  its  production,  and  the  result  must  be  a  satisfaction  to  the  editors 
as  it  is  a  gratification  to  the  conscientious  reader." 

Boston  Medical   <vnd  Surgical  Journal 

"The  articles  as  a  rule  present  the  essentials  of  the  subject  treated  in  a  clear,  concise  manner. 
They  are  systematically  written.  The  illustrations  are  abundant,  well  chosen,  and  enhance  greatly 
the  value  of  the  work.  The  book  is  a  thoroughly  modern  one." 

The  MediceJ  Record,  New  York 

"The  arrangement  of  subjects  is  excellent,  and  their  treatment  by  the  different  authors  Is 
equally  so.  ...  The  work  is  up  to  date  in  a  very  remarkable  degree,  many  of  the  latest  operations  in 
the  different  regional  parts  of  the  body  being  given  in  full  details.  There  is  not  a  chapter  in  the  worJe 
from  which  the  reader  may  not  learn  something  new." 


SAUNDERS'  BOOKS    ON 


American 
Text-Book  of  Surgery 

American  Text-Book  of  Surgery.  Edited  by  WILLIAM  W.  KEEN, 
M.  D.,  LL.  D.,  F.  R.  C.  S.  (Hon.),  and  J.  WILLIAM  WHITE,  M.  D.,  PH.  D. 
Octavo,  1363  pages,  with  551  text-cuts  and  39  colored  and  half-tone 
plates.  Cloth,  $7.00  net ;  Sheep  or  Half  Morocco,  $8.00  net. 

FOURTH  EDITION,  REVISED  AND  ENLARGED— RECENTLY  ISSUED 

Of  the  three  former  editions  of  this  book  there  have  been  sold  over  40,000 
copies.  In  this  present  edition  every  chapter  has  been  extensively  modified,  and 
many  of  them  have  been  partially,  and  some  entirely,  rewritten.  Six  entirely 
new  chapters  appear:  Military  Surgery,  by  Brigadier-General  R.  W.  O'Reilly, 
Surgeon-General,  U.  S.  Army,  and  Major  W.  C.  Borden,  Surgeon,  U.  S.  Army  ; 
Naval  Surgery,  by  Admiral  P.  M.  Rixey,  Surgeon-General,  U.  S.  Navy  ;  Tropical 
Surgery,  by  Captain  Charles  F.  Kieffer,  Assistant  Surgeon,  U.  S.  Army  ;  Examina- 
tion of  the  Blood,  by  Dr.  Richard  C.  Cabot  ;  Immunity,  by  Dr.  Arthur  K.  Stone  ; 
and  Surgery  of  the  Pancreas,  by  Dr.  Francis  J.  Shepherd. 

Edmund  Owen,  F.R.C.S. 

Member  of  the  Board  of  Examiners  of  the  Royal  College  of  Surgeons,  England. 
"  Personally,  I  should  not  mind  it  being  called  The  Text-Book  (instead  of  A  Text-Book), 
for  I  know  of  no  single  volume  which  contains  so  readable  and  complete  an  account  of  the 
science  and  art  of  surgery  as  this  does." 

Eisendrath's  Clinical  Anatomy 

A  Text-Book  of  Clinical  Anatomy.  By  DANIEL  N.  EISENDRATH, 
A.  B.,  M.  D.,  Adjunct  Professor  of  Surgery  and  Clinical  Surgery,  College 
of  Physicians  and  Surgeons,  Chicago.  Octavo  of  5 15  pages,  illustrated. 
Cloth,  $5.00  net;  Sheep  or  Half  Morocco,  $6.00  net. 

RECENTLY  ISSUED 

This  new  anatomy  discusses  the  subject  from  the  clinical  standpoint.  A  por- 
tion of  each  chapter  is  devoted  to  the  examination  of  the  living  through  palpation 
and  marking  of  surface  outlines  of  landmarks,  vessels,  nerves,  thoracic  and 
abdominal  viscera.  The  illustrations  are  from  new  and  original  drawings  and 
photographs. 

Medical  Record,  New  York 

"A  special  recommendation  for  the  figures  is  that  they  are  mostly  original  and  were 
made  for  the  purpose  in  view.  The  sections  of  joints  and  trunks  are  those  of  formalinized 
cadavers  and  are  unimpeachable  in  accuracy." 


SURGER  Y  AND  ANA  TO  Ml 


Schultze  arid  Stewart's 
Topographic  Anatomy 

Atlas  and  Text-Book  of  Topographic  and  Applied  Anatomy.     By 

PROF.  DR.  O.  SCHULTZE,  of  Wiirzburg.  Edited,  with  additions,  by 
GEORGE  D.  STEWART,  M.D.,  Professor  of  Anatomy  and  Clinical  Sur- 
gery, University  and  Bellevue  Hospital  Medical  College,  N.  Y.  Large 
quarto  of  189  pages,  with  25  colored  figures  on  22  colored  lithographic 
plates,  and  89  text-cuts,  60  in  colors.  Cloth,  $5.50  net. 

JUST   READY 

It  was  Professor  Schultze' s  special  aim,  in  preparing  this  work,  to  produce  a 
Text-Book  and  Atlas,  not  for  the  anatomist  alone,  but  more  particularly  for  the 
general  practitioner.  The  value  of  the  knowledge  of  topographic  anatomy  in  bed- 
side diagnosis  is  emphasized  throughout  the  book.  The  many  colored  lithographic 
plates  are  exceptionally  excellent. 

Arthur  Dean  Bevan,  M.  D.,  Professor  of  Surgery  in  Rush  Medical  College,  Chicago, 

"  I  regard  Schultze  and  Stewart's  Topographic  and  Applied  Anatomy  as  a  very  admirable 
work,  for  students  especially,  and  I  find  the  plates  and  the  text  excellent." 


Senn's  Surgery 

Practical  Surgery.  A  Work  for  the  General  Practitioner.  By 
NICHOLAS  SENN,  M.  D.,  PH.  D.,  LL.  D.,  Professor  of  Surgery  in  Rush 
Medical  College,  Chicago.  Octavo  of  1133  pages,  with  650  illustra- 
tions, many  in  colors.  Cloth,  $6.00  net ;  Sheep  or  Half  Morocco,  $7.00 
net.  Sold  by  Subscription. 

Based  on  His  Operative  Experience  of  25  Years 

This  book  deals  with  practical  subjects,  and  its  contents  are  devoted  to  those 
branches  of  surgery  that  are  of  special  interest  to  the  general  practitioner.  Special 
attention  is  paid  to  emergency  surgery,  shock,  hemorrhage,  and  wound  treatment 
being  fully  considered. 

Annals  of  Surgery 

"  It  is  of  value  not  only  as  presenting  comprehensively  the  most  advanced  teachings  of 
modern  surgery  in  the  subjects  which  it  takes  up,  but  also  as  a  record  of  the  matured  opinions 
and  practice  of  an  accomplished  and  experienced  surgeon." 


10  SAUNDERS*  BOOKS  ON 


Moderrv   Svirgery 

Modern  Surgery  —  GENERAL  AND  OPERATIVE.  By  JOHN  CHALMERS 
DACosTA,  M.D.,  Professor  of  the  Principles  of  Surgery  and  of  Clini- 
cal Surgery  in  the  Jefferson  Medical  College,  Philadelphia  ;  Surgeon 
to  Philadelphia  Hospital  and  to  St.  Joseph's  Hospital,  Philadelphia. 
Handsome  octavo  volume  of  1099  pages,  with  707  illustrations. 

Cloth,  $5.00  net  ;  Sheep  or  Half  Morocco,  $6.00  net 


FOURTH   EDITION— RECENTLY   ISSUED 
Thoroughly  Revised,  Entirely  Reset,  and  Greatly  Enlarged 

The  progress  of  surgery  in  every  department  is  one  of  the  most  notable 
phenomena  of  the  present  day.  So  many  improvements,  discoveries,  and 
observations  have  been  made  since  the  appearance  of  the  last  edition  of  this 
work  that  the  author  found  it  necessary  to  rewrite  it  entirely.  In  this  new  fourth 
edition  the  book  has  undergone  a  thorough  and  careful  revision,  and  there 
has  been  added  much  new  matter.  There  have  also  been  added  over  two 
hundred  excellent  and  practical  illustrations,  greatly  increasing  the  value  of  the 
work.  Because  of  the  great  amount  of  new  matter  it  has  been  deemed 
advisable  in  this  present  edition  to  adopt  a  larger  type  page.  This  is  a  great 
improvement,  rendering  as  it  does  the  work  less  cumbersome.  The  book  will 
be  found  to  express  the  latest  advances  in  the  art  and  science  of  surgery. 


OPINIONS  OF  THE  MEDICAL  PRESS 

The  Lancet,  London 

"  We-tnay  congratulate  Dr.  DaCosta  in  the  success  of  his  attempt.  .  .  .  We  can  recommend 
the  work  as  a  text-book  well  suited  to  students." 

The  Medical  Record,  New  York 

"  The  work  throughout  is  notable  for  its  conciseness.  Redundance  of  language  and  padding 
have  been  scrupulously  avoided,  while  at  the  same  time  it  contains  a  sufficient  amount  of  information 
to  fulfil  the  object  aimed  at  by  its  author — namely,  a  text-book  for  the  use  of  the  student  and  the 
busy  practitioner." 

American  Journal  of  the  Medical  Sciences 

"  The  author  has  presented  concisely  and  accurately  the  principles  of  modern  surgery.  The 
book  is  a  valuable  one,  which  can  be  recommended  to  students,  and  is  of  great  value  to  the  general 
practitioner." 


SURGER  Y  AND  ANA  TOMY  1 1 

GET  A     ^^^  m  •  THE  NEW 

THE  BEST      /JLlTYGriC  55crV     STANDARD 

Illustrated  Dictiorv».ry 

NEW  THIRD  REVISED  EDITION  — 1500  NEW  WORDS 

The  American    Illustrated    Medical    Dictionary.     A    New    and 

Complete  Dictionary  of  the  terms  used  in  Medicine,  Surgery,  Den- 
tistry, Pharmacy,  Chemistry,  and  kindred  branches.  With  tables  of 
Arteries,  Muscles,  Nerves,  Veins,  etc.;  of  Bacilli,  Bacteria,  etc.; 
Eponymic  Tables  of  Diseases,  Operations,  Stains,  Tests,  etc.  By 
W.  A.  NEWMAN  DORLAND,  M.D.  Large  octavo,  798  pages. 

Flexible  leather,  $4.50  net;  with  thumb  index,  $5.00  net. 

Howard  A.  Kelly.  M.D., 

Professor  of  Gynecology,  Johns  Hopkins  University,  Baltimore. 

"  Dr.  Dorland's  Dictionary  is  admirable.     It  is  so  well  gotten  up  and  of  such  convenient  size. 
No  errors  have  been  found  in  my  use  of  it." 

Golebiewski  and  Bailey's 
Accident  Diseases 

Atlas  and  Epitome  of  Diseases  Caused  by  Accidents.      By  DR. 

ED.  GOLEBIEWSKI,  of  Berlin.  Edited,  with  additions,  by  PEARCE 
BAILEY,  M.D.  Consulting  Neurologist  to  St.  Luke's  Hospital,  New 
York  City.  With  71  colored  figures  on  40  plates,  143  text-cuts,  and 
549  pages  of  text.  Cloth,  $4.00  net.  In  Saunders'  Hand- Atlas  Series. 

The  Medical  Record,  New  York 

"  This   volume  is  upon  an  important   and    only  recently  systematized  subject,  which  is 
growing  in  extent  all  the  time.     The  pictorial  part  of  the  book  is  very  satisfactory." 

HelfericK  aivd  Bloodgood's 
Fractures  and  Dislocations 

Atlas  and   Epitome  of  Traumatic  Fractures  and   Dislocations. 

By  PROF.  DR.  H.  HELFERICH,  of  Greifswald,  Prussia.  Edited,  with 
.additions,  by  JOSEPH  C.  BLOODGOOD,  M.D.,  Associate  in  Surgery, 
Johns  Hopkins  University,  Baltimore.  From  the  Fifth  Revised  and 
Enlarged  German  Edition.  216  colored  figures  on  64  lithographic 
plates,  190  text-cuts,  and  353  pages  of  text. 

Cloth,  $3.00  net.     In  Saunders1  Atlas  Series. 

Medical  News,  New  York 

"  The  author  and  editor  have  made  a  most  successful  effort  to  arrange  the  illustrations  that  the 
interpretation  of  what  they  are  intended  to  present  is  exceedingly  easy." 


12  SAUNDERS?  BOOKS  ON 

SviltQcrv  eo^d  Coley's 
Abdomirval  Hernias 

Atlas  and  Epitome  of  Abdominal  Hernias.  By  PR.  DR.  G.  SUL- 
TAN, of  Gottingen.  Edited,  with  additions,  by  WM.  B.  COLEY,  M.D., 
Clinical  Lecturer  and  Instructor  in  Surgery,  Columbia  University,  New 
York.  1 19  illustrations,  36  in  colors,  and  277  pages  of  text. 

Cloth,  $3.00  net.     In  Saunders1  Hand-Atlas  Serifs. 

Robert  H.  M.  Dawbarn.  M.D.. 

Professor  of  Surgery  and  of  Surgical  Anatomy,  jVe?v  York  Polyclinic. 

"  I  have  spent  several  interesting  hours  over  it  to-day,  and  shall  willingly  recommend  it  to  my 
classes  at  the  Polyclinic  College  and  elsewhere." 

Warren's  Pathology  and  Therapeutics 

Surgical  Pathology  and  Therapeutics.     By  J.  COLLINS  WARREN, 
M.D.,  LL.D.,  F.R.C.S.  (Hon.),  Professor  of  Surgery,  Harvard  Medi- 
cal   School.      Octavo,    873    pages;     136   illustrations,    33   in    colors. 
With  an  Appendix  on  Surgical  Diagnosis  and  Regional  Bacteriology. 
Cloth,  $5.00  net;  Sheep  or  Half  Morocco,  $6.00  net. 

SECOND  EDITION,  WITH   AN  APPENDIX 

Roswell  Park.  M.D., 

In  the  Harvard  Graduate  Magazine. 

"  I  think  it  is  the  most  creditable  book  on  surgical  pathology,  and  the  most  beautiful  medical 
illustration  of  the  bookmakers'  art  that  has  ever  been  issued  from  the  American  press." 

ZuckerkdLiidl  and  DaXostaJs 
Operative  S\irgery 

ADOPTED  BY  THE  U.  S.  AR.MY 

Atlas  and  Epitome  of  Operative  Surgery.  By  DR.  O.  ZUCKER- 
KANDL,  of  Vienna.  Edited,  with  additions,  by  J.  CHALMERS  DACOSTA, 
M.D.,  Professor  of  the  Principles  of  Surgery  and  Clinical  Surgery, 
Jefferson  Medical  College,  Phila.  40  colored  plates,  278  text-cuts, 
and  410  pages  of  text.  Cloth,  $3.50  net.  In  Saunders'  Atlas  Series. 

SECOND  EDITION.  THOROUGHLY  REVISED  AND  GREATLY  ENLARGED 

New  York  Medical  Journal. 

"  We  know  of  no  other  work  upon  the  subject  in  which  the  illustrations  are  as  numerous  or  as 
generally  satisfactory," 


SURGERY  AND  ANATOMY  13 

Lewis'  Anatomy  and  Physiology  for  Nurses      Jt»t  issued 

Anatomy  and  Physiology  for  Nurses.  By  LnRoY  LEWIS,  M.  D.,  Surgeon 
to  and  Lecturer  on  Anatomy  and  Physiology  for  Nurses  at  the  Lewis  Hospital, 
Bay  City,  Michigan.  I2mo,  317  pages,  with  146 illustrations.  Cloth,  $1.75  net. 

A  demand  for  such  a  work  as  this,  treating  the  subjects  from  the  nurse's  point  of  view, 
has  long  existed.  Dr.  Lewis  has  based  the  plan  and  scope  of  this  work  on  the  methods  em- 
ployed by  him  in  teaching  these  branches,  making  the  text  unusually  simple  and  clear. 
The  object  was  so  to  deal  with  anatomy  and  physiology  that  the  student  might  easily 
grasp  the  primary  principles,  at  the  same  time  laying  a  broad  foundation  for  wider  study. 


McClellan's  Art  Anatomy  Recently  issued 

Anatomy  in  Its  Relation  to  Art.  By  GEORGE  McCLELLAN,  M.D.,  Professor 
of  Anatomy,  Pennsylvania  Academy  of  the  Fine  Arts.  Quarto  volume,  9  by 
12^  inches,  with  338  original  drawings  and  photographs,  and  260  pages  of 
text.  Dark  blue  vellum,  $10.00  net  ;  Half  Russia,  $12.00  net. 

Howard  Pyle,  in  the  Philadelphia  Medical  Journal 

"The  book  is  one  of  the  best  and  the  most  thorough  text-books  of  artistic  anatomy  which  it  has  been 
the  writer's  fortune  to  fall  upon,  and,  as  a  text-book,  it  ought  to  make  its  way  into  the  field  for  which 
it  is  intended." 


On         limOrS  Second  Revised  Edition 

Pathology  and  Surgical  Treatment  of  Tumors.  By  NICHOLAS  SENN, 
M.D.,  PH.D.,  LL.D.,  Professor  of  Surgery,  Rush  Medical  College,  Chicago. 
Handsome  octavo,  718  pages,  with  478  engravings,  including  12  full-page 
colored  plates.  Cloth,  $5.00  net  ;  Sheep  or  Half  Morocco,  $6.00  net. 

Journal  of  the  American  Medical  Association 

"  The  most  exhaustive  of  any  recent  book  in  English  on  this  subject.  Itjs  well  illustrated  and  will 
doubtless  remain  as  the  principal  monograph  on  the  subject  for  some  years." 


MacdonalcTs  Diagnosis  and  Treatment 

A  Clinical  Text-Book  of  Surgical  Diagnosis  and  Treatment.     By  J.  W. 

MACDONALD,  M.D.  Edin.,  F.R.C.S.  (Edin.),  Professor  Emeritus  of  the  Prac- 
tice of  Surgery  and  of  Clinical  Surgery  in  Hamline  University,  Minneapolis. 
Octavo,  798  pages,  illus.  Cloth,  $5.00  net ;  Sheep  or  Half  Mor.,  56.00  net 

British  Medical  Journal 

"Care  has  been  taken  to  lay  down  rules  for  a  systematic  and  comprehensive  examination  of  each  case 
as  it  presents  itself,  and  the  most  advanced  and  approved  methods  of  clinical  investigation  in  surgical 
practice  are  fully  described  " 


14  SAUNDERS'   BOOKS   ON 

Haynes*  Anatomy 

A  Manual  of  Anatomy.  By  IRVING  S.  HAYNES,  M.D.,  Professor  of  Prac- 
tical Anatomy,  Cornell  University  Medical  College.  Octavo,  680  pages, 
with  42  diagrams  and  134  full-page  half-tones.  Cloth,  $2.50  net. 

"  This  book  is  the  work  of  a  practical  instructor—  one  who  knows  by  experience  the  require- 
ments of  the  average  student,  and  is  able  to  meet  these  requirements  in  a  very  satisfactory 
way."  —  The  Medical  Record,  New  York. 

American  Pocket  Dictionary 

The  American  Pocket  Medical  Dictionary.  Edited  by  W.  A.  NEWMAN 
BORLAND,  A.M.,  M.D.,  Assistant  Obstetrician,  Hospital  of  the  University  of 
Pennsylvania,  etc.  566  pages.  Full  leather,  limp,  with  gold  edges,  $1.00 
net;  with  patent  thumb  index,  $1.25  net. 

"  I  am  struck  at  once  with  admiration  at  the  compact  size  and  attractive  exterior.  I  can  recom- 
mend it  to  our  students  without  reserve."  —  JAMES  W.  HOLLAND,  M.D.,  Professor  of  Medical 
Chemistry  and  Toxicology,  and  Dean,  Jefferson  Medical  College,  Philadelphia. 

Beck's  Fractures 

Fractures.  By  CARL  BECK,  M.D.,  Professor  of  Surgery,  New  York  Post- 
graduate Medical  School  and  Hospital.  With  an  Appendix  on  the  Practical 
Use  of  the  Rontgen  Rays.  335  pages,  170  illustrations.  Cloth,  $3.50  net. 

"  The  use  of  the  rays  with  its  technic  is  fully  explained,  and  the  practical  points  are  brought  out 
with  a  thoroughness  that  merits  high  praise."—  The  Medical  Record,  New  York. 

Barton  and  Wells'  Medical  Thesaurus          Recently  issued 

A  Thesaurus  of  Medical  Words  and  Phrases.  By  WILFRED  M.  BARTON, 
M.  D.,  Assistant  to  Professor  of  Materia  Medica  and  Therapeutics,  and  Lec- 
turer on  Pharmacy,  Georgetown  University,  Washington,  D.  C.  ;  and  WALTER 
A.  WELLS,  M.  D.,  Demonstrator  of  Laryngology,  Georgetown  University, 
Washington,  D.  C.  i2mo  of  534  pages.  Flexible  leather,  $2.50  net  ;  with 
thumb  index,  $3.00  net. 


Stoney's  Surgical  Technic 

Bacteriology  and  Surgical  Technic  for  Nurses.  By  EMILY  M.  A.  STONEY, 
Superintendent  at  the  Carney  Hospital,  South  Boston,  Mass.  Revised  by 
FREDERIC  R.  GRIFFITH,  M.  D.,  Surgeon,  of  New  York.  i2mo,  266  pages, 
illustrated.  #1.50  net. 

"  These  subjects  are  treated  most  accurately  and  up  to  date,  without  the  superfluous  reading 
which  is  so  often  employed.  .  .  .  Nurses  will  find  this  book  of  the  greatest  value.  "- 
Trained  Nurse  and  Hospital  Review. 

Grant  on  Face,  Mouth,  and  Jaws 

A  Text-  Book  of  the  Surgical  Principles  and  Surgical  Diseases  of  the 
Face,  Mouth,  and  Jaws.  For  Dental  Students.  By  H.  HORACE  GRANT, 
A.M.,  M.D.,  Professor  of  Surgery  and  of  Clinical  Surgery,  Hospital  College 
of  Medicine.  Octavo  of  231  pages,  with  68  illustrations.  Cloth,  $2.50  net. 

"  The  language  of  the  book  is  simple  and  clear.  .  .  .  We  recommend  the  work  to  those  for 
whom  it  is  intended."—  Philadelphia  Medical  Journal. 


SURGER  Y  AND  ANA  TOMY  I  j 

Warwick  and  Tunstall's  First  Aid 

First  Aid  to  the  Injured  and  Sick.  By  F.  J.  WARWICK,  B.A.,  M.B. 
Cantab.,  Associate  of  King's  College,  London  ;  and  A.  C.  TUNSTALL,  M.D., 
F.R.C.S.  Edin.,  Surgeon-Captain  Commanding  the  East  London  Volunteer 
Brigade  Bearer  Company.  i6mo  of  232  pages  and  nearly  200  illustrations. 

Cloth,  $1.00  net. 

"  Contains  a  great  deal  of  valuable  information  well  and  tersely  expressed.  It  will  prove 
especially  useful  to  the  volunteer  first  aid  and  hospital  corps  men  of  the  National  Guard."— 
Journal  American  Medical  Association. 

Beck's  Svirgical  Asepsis 

A  Manual  of  Surgical  Asepsis.  By  CARL  BECK,  M.D.,  Professor  of  Sur- 
gery, New  York  Post-graduate  Medical  School  and  Hospital.  306  pages  ;  65 
text-illustrations  and  12  full-page  plates.  Cloth,  $1.25  net. 

"  The  book  is  well  written.  The  data  are  clearly  and  concisely  given.  The  facts  are  well 
arranged.  It  is  well  worth  reading  to  the  student,  the  physician  in  general  practice,  and  the 
surgeon." — Boston  Medical  and  Surgical  Journal. 

Griffith's  Hand-Book  of  Surgery  Recently  issued 

A  Manual  of  Surgery.  By  FREDERIC  R.  GRIFFITH,  M.  D.,  Surgeon  to  the 
Bellevue  Dispensary,  New  York  City.  I2mo  of  579  pages,  with  417  illus- 
trations. Flexible  leather,  $2.00  net. 

"  Well  adapted  to  the  needs  of  the  student  and  to  the  busy  practitioner  for  a  hasty  review  of  important 
points  in  surgery." — American  Medicine. 

Senn's  Syllabus  of  Surgery 

A  Syllabus  of  Lectures  on  the  Practice  of  Surgery.  Arranged  in  con- 
formity with  "American  Text-Book  of  Surgery."  By  NICHOLAS  SENN, 
M.D.,  PH.D.,  LL.D.,  Professor  of  Surgery,  Rush  Medical  College,  Chicago. 

Cloth,  $1.50  net. 

"  The  author  has  evidently  spared  no  pains  in  making  his  Syllabus  thoroughly  comprehensive, 
and  has  added  new  matter  and  alluded  to  the  most  recent  authors  and  operations.  Full  refer- 
ences are  also  given  to  all  requisite  details  of  surgical  anatomy  and  pathology." — British  Medi- 
cal Journal. 

Keen's  Addresses  and  Other  Papers  Just  Ready 

Addresses  and  Other  Papers.  Delivered  by  WILLIAM  W.  KEEN,  M.  D. , 
LL.D.,  F.  R.  C.  S.  (Hon.),  Professor  of  the  Principles  of  Surgery  and  of  Clin- 
ical Surgery,  Jefferson  Medical  College,  Philadelphia.  Octavo  volume  of 
441  pages,  illustrated.  Cloth,  $3.75  net. 

Keen  on  the  Surgery  of  Typhoid 

The  Surgical  Complications  and  Sequels  of  Typhoid  Fever.     By  WM.  W. 

KEEN,  M.D.,  LL.D.,  F.R.C.S.  (Hon.),  Professor  of  the  Principles  of  Surgery 
and  of  Clinical  Surgery,  Jefferson  Medical  College,  Philadelphia,  etc. 
Octavo  volume  of  386  pages,  illustrated.  Cloth,  $3.00  net. 

"  Every  surgical  incident  which  can  occur  during  or  after  typhoid  fever  is  amply  discussed  and 
fully  illustrated  by  cases.  .  .  .  The  book  will  be  useful  both  to  the  surgeon  and  physician.  — 
The  Practitioner,  London. 


1  6  S  UR  GER  Y  AND  ANA  TO  MY 

Moore's  Orthopedic  Surgery 

A  Manual  of  Orthopedic  Surgery.  By  JAMES  E.  MOORE,  M.D.,  Professor 
of  Clinical  Surgery,  University  of  Minnesota,  College  of  Medicine  and  Surgery. 
Octavo  0^356  pages,  handsomely  illustrated.  Cloth,  $2.50  net. 

"The  book  is  eminently  practical.  It  is  a  safe  guide  in  the  understanding  and  treatment  oi 
orthopedic  cases.  Should  be  owned  by  every  surgeon  and  practitioner."  —  Annals  of  Surgery. 


Nancrede's   Anatomy  and   Dissection. 

Essentials    of    Anatomy  and    Manual    of    Practical    Dissection.      By 

CHARLES  B.  NANCREDE,  M.D.,  Professor  of  Surgery  and  of  Clinical  Surgery, 
University  of  Michigan,  Ann  Arbor.  Post-octavo;  500  pages,  with  full-page 
lithographic  plates  in  colors,  and  nearly  200  illustrations. 

Extra  Cloth  (or  Oilcloth  for  the  dissecting-room),  $2.00  net. 

"  The  plates  are  of  more  than  ordinary  excellence,  and  are  of  especial  value  to  students  in  their 
work  in  the  dissecting-room."—;  Journal  of  the  American  Medical  Association. 

Nancrede's  Principles  of  Surgery      New"  zd  "edition 

Lectures  on  the  Principles  of  Surgery.  By  CHAS.  B.  NANCREDE,  M.D., 
LL.D.,  Professor  of  Surgery  and  of  Clinical  Surgery,  University  of  Michigan, 
Ann  Arbor.  Octavo,  407  pages,  illustrated.  Cloth,  $2.50  net. 

"  We  can  strongly  recommend  this  book  to  all  students  and  those  who  would  see  something 
of  the  scientific  foundation  upon  which  the  art  of  surgery  is  built."  —  Quarterly  Medical  Journal, 
Sheffield,  England. 


Nancrede's  Essentials  of  Anatomy. 

Essentials  of  Anatomy,  including  the  Anatomy  of  the  Viscera.  By  CHAS. 
B.  NANCREDE,  M.  D.  ,  Professor  of  Surgery  and  of  Clinical  Surgery,  University 
of  Michigan,  Ann  Arbor.  Crown  octavo,  388  pages  ;  1  80  cuts.  With  an 
Appendix  containing  over  60  illustrations  of  the  osteology  of  the  body.  Based 
on  Gray"  s  Anatomy.  Cloth,  $1.00  net.  In  Saunders'  Question  Compends. 

"  The  questions  have  been  wisely  selected,  and  the  answers  accurately  and  concisely  given."— 
University  Medical  Magazine. 

Martin's  Essentials  of  Surgery.     SeveRevifeditioIX 

Essentials  of  Surgery.  Containing  also  Venereal  Diseases,  Surgical  Land- 
marks, Minor  and  Operative  Surgery,  and  a  complete  description,  with  illus- 
trations, of  the  Handkerchief  and  Roller  Bandages.  By  EDWARD  MARTIN, 
A.M.,  M.D.,  Professor  of  Clinical  Surgery,  University  of  Pennsylvania,  etc. 
Crown  octavo,  338  pages,  illustrated.  With  an  Appendix  on  Antiseptic  Sur- 
gery, etc.  Cloth,  $1.00  net.  In  Saunders  Question  Compends. 

"  Written  to  assist  the  student,  it  will  be  of  undoubted  value  to  the  practitioner,  containing  as  it 
does  the  essence  of  surgical  work."  —  Boston  Medical  and  Surgical  Journal. 

Martin's   Essentials  of  Minor  Surgery,  Band- 
aging,   and   Venereal    Diseases.       SeoT&S£vfaad 

Essentials  of  Minor  Surgery,  Bandaging,  and  Venereal  Diseases.    By 

EDWARD  MARTIN,  A.M.,  M.D.,  Professor  of  Clinical  Surgery,  University  of 
Pennsylvania,  etc.  Crown  octavo,  1  66  pages,  with  78  illustrations. 

Cloth,  $1.00  net.     In  Saunders'  Question  Compends. 

"  The  best  condensation  of  the  subjects  of  which  it  treats  yet  placed  before  the  profession  "— 
The  Medical  JVeurs,  Philadelphia. 


DATE  DUE 


GAYLORD 


PRINTED  IN  U    S   A 


A  000  509  983  3 


W  21 


1905 
Mathewp,  Joseph  McDowell. 

How  to  succeed  in  the  practice  of 
medicine 


MEDICAL  SCIENCES  LIBRARY 

UNIVERSITY  OF  CALIFORNIA,  IRVINE 
IRVINF    P.AI  IFORNIA 


